II

103D CONGRESS

2D SESSION S. 2433

To amend title VIII of the Public Health Service Act to consolidate and

reauthorize nursing education programs under such title, and for other

purposes.

IN THE SENATE OF THE UNITED STATES

SEPTEMBER 13 (legislative day, SEPTEMBER 12), 1994

Mr. KENNEDY (for himself and Mrs. KASSEBAUM) introduced the following

bill; which was read twice and referred to the Committee on Labor and

Human Resources

A BILL

To amend title VIII of the Public Health Service Act to

consolidate and reauthorize nursing education programs

under such title, 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 ‘‘Nursing Education

5 Consolidation and Reauthorization Act of 1994’’.

6 SEC. 2. PURPOSE.

7 It is the purpose of this Act to restructure the nurse

8 education authorities of title VIII of the Public Health

9 Service Act to permit a comprehensive, flexible, and effec-
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1 tive approach to Federal support for nursing workforce

2 development.

3 SEC. 3. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

4 Title VIII of the Public Health Service Act (42

5 U.S.C. 296k et seq.) is amended—

6 (1) by striking the title heading and all that fol7 lows except for subparts II and III of part B and

8 section 855; and inserting the following:

9 ‘‘TITLE VIII—NURSING

10 WORKFORCE DEVELOPMENT’’;

11 (2) in subpart II of part B, by striking the sub12 part heading and inserting the following:

13 ‘‘PART E—STUDENT LOANS

14 ‘‘Subpart I—General Program’’;

15 (3) by redesignating subpart III as subpart II;

16 (4) by striking section 837;

17 (5) in section 846, by striking subsection (d)

18 and inserting the following new subsection:

19 ‘‘(d) BREACH OF AGREEMENTS FOR OBLIGATED

20 SERVICE.—

21 ‘‘(1) IN GENERAL.—In the case of any program

22 under this section under which an individual makes

23 an agreement to provide health services for a period

24 of time in accordance with such program in consid25 eration of receiving an award of Federal funds re-
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1 garding education as a nurse (including an award

2 for the repayment of loans), the following applies if

3 the agreement provides that this subsection is appli4 cable:

5 ‘‘(A) In the case of a program under this

6 section that makes an award of Federal funds

7 for attending an accredited program of nursing

8 (in this subsection referred to as a ‘nursing pro9 gram’), the individual is liable to the Federal

10 Government for the amount of such award (in11 cluding amounts provided for expenses related

12 to such attendance), and for interest on such

13 amount at the maximum legal prevailing rate,

14 if the individual—

15 ‘‘(i) fails to maintain an acceptable

16 level of academic standing in the nursing

17 program (as indicated by the program in

18 accordance with requirements established

19 by the Secretary);

20 ‘‘(ii) is dismissed from the nursing

21 program for disciplinary reasons; or

22 ‘‘(iii) voluntarily terminates the nurs23 ing program.

24 ‘‘(B) The individual is liable to the Federal

25 Government for the amount of such award (in-
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1 cluding amounts provided for expenses related

2 to such attendance), and for interest on such

3 amount at the maximum legal prevailing rate,

4 if the individual fails to provide health services

5 in accordance with the program under this sec6 tion for the period of time applicable under the

7 program.

8 ‘‘(2) WAIVER OR SUSPENSION OF LIABILITY.—

9 In the case of an individual or health facility making

10 an agreement for purposes of paragraph (1), the

11 Secretary shall provide for the waiver or suspension

12 of liability under such paragraph if compliance by

13 the individual or the health facility, as the case may

14 be, with the agreements involved is impossible, or

15 would involve extreme hardship to the individual or

16 facility, and if enforcement of the agreements with

17 respect to the individual or facility would be uncon18 scionable.

19 ‘‘(3) DATE CERTAIN FOR RECOVERY.—Subject

20 to paragraph (2), any amount that the Federal Gov21 ernment is entitled to recover under paragraph (1)

22 shall be paid to the United States not later than the

23 expiration of the 3-year period beginning on the date

24 the United States becomes so entitled.
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1 ‘‘(4) AVAILABILITY.—Amounts recovered under

2 paragraph (1) with respect to a program under this

3 section shall be available for the purposes of such

4 program, and shall remain available for such pur5 poses until expended.’’;

6 (6) by inserting after the title heading the fol7 lowing new parts:

8 ‘‘PART A—GENERAL PROVISIONS

9 ‘‘SEC. 801. DEFINITIONS.

10 ‘‘As used in this title:

11 ‘‘(1) ELIGIBLE ENTITIES.—The term ‘eligible

12 entities’ means schools of nursing, nursing centers,

13 State or local governments, and other public or non14 profit private entities determined appropriate by the

15 Secretary that submit to the Secretary an applica16 tion in accordance with section 802.

17 ‘‘(2) SCHOOL OF NURSING.—The term ‘school

18 of nursing’ means a collegiate, associate degree, or

19 diploma school of nursing in a State.

20 ‘‘(3) COLLEGIATE SCHOOL OF NURSING.—The

21 term ‘collegiate school of nursing’ means a depart22 ment, division, or other administrative unit in a col23 lege or university which provides primarily or exclu24 sively a program of education in professional nursing

25 and related subjects leading to the degree of bach-
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1 elor of arts, bachelor of science, bachelor of nursing,

2 or to an equivalent degree, or to a graduate degree

3 in nursing, and including advanced training related

4 to such program of education provided by such

5 school, but only if such program, or such unit, col6 lege or university is accredited.

7 ‘‘(4) ASSOCIATE DEGREE SCHOOL OF NURS8 ING.—The term ‘associate degree school of nursing’

9 means a department, division, or other administra10 tive unit in a junior college, community college, col11 lege, or university which provides primarily or exclu12 sively a two-year program of education in profes13 sional nursing and allied subjects leading to an asso14 ciate degree in nursing or to an equivalent degree,

15 but only if such program, or such unit, college, or

16 university is accredited.

17 ‘‘(5) DIPLOMA SCHOOL OF NURSING.—The

18 term ‘diploma school of nursing’ means a school af19 filiated with a hospital or university, or an independ20 ent school, which provides primarily or exclusively a

21 program of education in professional nursing and al22 lied subjects leading to a diploma or to equivalent

23 indicia that such program has been satisfactorily

24 completed, but only if such program, or such affili-
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1 ated school or such hospital or university or such

2 independent school is accredited.

3 ‘‘(6) ACCREDITED.—

4 ‘‘(A) IN GENERAL.—Except as provided in

5 subparagraph (B), the term ‘accredited’ when

6 applied to any program of nurse education

7 means a program accredited by a recognized

8 body or bodies, or by a State agency, approved

9 for such purpose by the Secretary of Education

10 and when applied to a hospital, school, college,

11 or university (or a unit thereof) means a hos12 pital, school, college, or university (or a unit

13 thereof) which is accredited by a recognized

14 body or bodies, or by a State agency, approved

15 for such purpose by the Secretary of Education.

16 For the purpose of this paragraph, the Sec17 retary of Education shall publish a list of recog18 nized accrediting bodies, and of State agencies,

19 which the Secretary of Education determines to

20 be reliable authority as to the quality of edu21 cation offered.

22 ‘‘(B) NEW PROGRAMS.—A new school of

23 nursing that, by reason of an insufficient period

24 of operation, is not, at the time of the submis25 sion of an application for a grant or contract
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1 under this title, eligible for accreditation by

2 such a recognized body or bodies or State agen3 cy, shall be deemed accredited for purposes of

4 this title if the Secretary of Education finds,

5 after consultation with the appropriate accredi6 tation body or bodies, that there is reasonable

7 assurance that the school will meet the accredi8 tation standards of such body or bodies prior to

9 the beginning of the academic year following

10 the normal graduation date of students of the

11 first entering class in such school.

12 ‘‘(7) NONPROFIT.—The term ‘nonprofit’ as ap13 plied to any school, agency, organization, or institu14 tion means one which is a corporation or association,

15 or is owned and operated by one or more corpora16 tions or associations, no part of the net earnings of

17 which inures, or may lawfully inure, to the benefit

18 of any private shareholder or individual.

19 ‘‘(8) STATE.—The term ‘State’ means a State,

20 the Commonwealth of Puerto Rico, the District of

21 Columbia, the Commonwealth of the Northern Mari22 ana Islands, Guam, American Samoa, the Virgin Is23 lands, or the Trust Territory of the Pacific Islands.
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1 ‘‘SEC. 802. APPLICATION.

2 ‘‘(a) IN GENERAL.—To be eligible to receive a grant

3 or contract under this title, an eligible entity shall prepare

4 and submit to the Secretary an application that meets the

5 requirements of this section, at such time, in such manner,

6 and containing such information as the Secretary may re7 quire.

8 ‘‘(b) PLAN.—An application submitted under this

9 section shall contain the plan of the applicant for carrying

10 out a project with amounts received under this title. Such

11 plan shall be consistent with relevant Federal, State, or

12 regional program plans.

13 ‘‘(c) PERFORMANCE OUTCOME STANDARDS.—An ap14 plication submitted under this section shall contain a spec15 ification by the applicant entity of performance outcome

16 standards that the project to be funded under the grant

17 or contract will be measured against. Such standards shall

18 address relevant national nursing needs that the project

19 will meet. The recipient of a grant or contract under this

20 section shall meet the standards set forth in the grant or

21 contract application.

22 ‘‘(d) LINKAGES.—An application submitted under

23 this section shall contain a description of the linkages with

24 relevant educational and health care entities, including

25 training programs for other health professionals as appro-
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1 priate, that the project to be funded under the grant or

2 contract will establish.

3 ‘‘SEC. 803. USE OF FUNDS.

4 ‘‘(a) IN GENERAL.—Amounts provided under a grant

5 or contract awarded under this title may be used for train6 ing program development and support, faculty develop7 ment, model demonstrations, trainee support including

8 tuition, books, program fees and reasonable living ex9 penses during the period of training, technical assistance,

10 workforce analysis, and dissemination of information, as

11 appropriate to meet recognized nursing objectives, in ac12 cordance with this title.

13 ‘‘(b) MAINTENANCE OF EFFORT.—With respect to

14 activities for which a grant awarded under this title is to

15 be expended, the entity shall agree to maintain expendi16 tures of non-Federal amounts for such activities at a level

17 that is not less than the level of such expenditures main18 tained by the entity for the fiscal year preceding the fiscal

19 year for which the entity receives such a grant.

20 ‘‘SEC. 804. MATCHING REQUIREMENT.

21 ‘‘The Secretary may require that an entity that ap22 plies for a grant or contract under this title provide non23 Federal matching funds, as appropriate, to ensure the in24 stitutional commitment of the entity to the projects funded

25 under the grant. Such non-Federal matching funds may
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1 be provided directly or through donations from public or

2 private entities and may be in cash or in-kind, fairly evalu3 ated, including plant, equipment, or services.

4 ‘‘SEC. 805. PREFERENCE.

5 ‘‘In awarding grants or contracts under this title, the

6 Secretary shall give preference to applicants with projects

7 that will substantially benefit rural or underserved popu8 lations.

9 ‘‘SEC. 806. GENERALLY APPLICABLE PROVISIONS.

10 ‘‘(a) AWARDING OF GRANTS AND CONTRACTS.—The

11 Secretary shall ensure that grants and contracts under

12 this title are awarded on a competitive basis to carry out

13 innovative demonstration projects or provide for strategic

14 workforce supplementation activities as needed to meet

15 national nursing service goals and in accordance with this

16 title.

17 ‘‘(b) INFORMATION REQUIREMENTS.—Recipients of

18 grants and contracts under this title shall meet informa19 tion requirements as specified by the Secretary.

20 ‘‘(c) TRAINING PROGRAMS.—Training programs con21 ducted with amounts received under this title shall meet

22 applicable accreditation and quality standards.

23 ‘‘(d) DURATION OF ASSISTANCE.—

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

25 in the case of an award to an entity of a grant, co-
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1 operative agreement, or contract under this title, the

2 period during which payments are made to the en3 tity under the award may not exceed 5 years. The

4 provision of payments under the award shall be sub5 ject to annual approval by the Secretary of the pay6 ments and subject to the availability of appropria7 tions for the fiscal year involved to make the pay8 ments. This paragraph may not be construed as lim9 iting the number of awards under the program in10 volved that may be made to the entity.

11 ‘‘(2) LIMITATION.—In the case of an award to

12 an entity of a grant, cooperative agreement, or con13 tract under this title, paragraph (1) shall apply only

14 to the extent not inconsistent with any other provi15 sion of this title that relates to the period during

16 which payments may be made under the award.

17 ‘‘(e) PEER REVIEW REGARDING CERTAIN PRO18 GRAMS.—Each application for a grant under this title, ex19 cept advanced nurse traineeship grants under section

20 811(e), shall be submitted to a peer review group for an

21 evaluation of the merits of the proposals made in the ap22 plication. The Secretary may not approve such an applica23 tion unless a peer review group has recommended the ap24 plication for approval. Each peer review group under this

25 subsection shall be composed principally of individuals who
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1 are not officers or employees of the Federal Government.

2 This subsection shall be carried out by the Secretary act3 ing through the Administrator of the Health Resources

4 and Services Administration.

5 ‘‘SEC. 807. NATIONAL ADVISORY COUNCIL ON NURSE EDU6 CATION AND PRACTICE.

7 ‘‘(a) ESTABLISHMENT.—There is hereby established

8 a National Advisory Council on Nurse Education and

9 Practice (in this section referred to as the ‘Council’), con10 sisting of the Secretary or the delegate of the Secretary

11 (who shall be an ex officio member and shall serve as the

12 Chairperson), and 15 members appointed by the Secretary

13 without regard to the Federal civil service laws, of which—

14 ‘‘(1) 2 shall be selected from full-time students

15 enrolled in schools of nursing;

16 ‘‘(2) 3 shall be selected from the general public;

17 ‘‘(3) 2 shall be selected from practicing profes18 sional nurses; and

19 ‘‘(4) 8 shall be selected from among the leading

20 authorities in the various fields of nursing, higher,

21 and secondary education, and from representatives

22 of hospitals and other institutions and organizations

23 which provide nursing services.

24 A majority of the members shall be nurses. The student25 members of the Council shall be appointed for terms of
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1 one year and shall be eligible for reappointment to the

2 Council.

3 ‘‘(b) DUTIES.—The Council shall advise the Sec4 retary in the preparation of general regulations and with

5 respect to policy matters arising in the administration of

6 this title, including the range of issues relating to nurse

7 supply, education and practice improvement.

8 ‘‘(c) FUNDING.—Amounts appropriated under this

9 title may be utilized by the Secretary to support the nurse

10 education and practice activities of the Council.

11 ‘‘SEC. 808. TECHNICAL ASSISTANCE.

12 ‘‘Funds appropriated under this title may be used by

13 the Secretary to provide technical assistance in relation

14 to any of the authorities under this title.

15 ‘‘SEC. 809. RECOVERY FOR CONSTRUCTION ASSISTANCE.

16 ‘‘(a) IN GENERAL.—If at any time within 20 years

17 (or within such shorter period as the Secretary may pre18 scribe by regulation for an interim facility) after the com19 pletion of construction of a facility with respect to which

20 funds have been paid under subpart I of part A (as such

21 subpart was in effect on September 30, 1985)—

22 ‘‘(1) the owner of the facility ceases to be a

23 public or nonprofit school,

24 ‘‘(2) the facility ceases to be used for the train25 ing purposes for which it was constructed, or
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1 ‘‘(3) the facility is used for sectarian instruction

2 or as a place for religious worship,

3 the United States shall be entitled to recover from the

4 owner of the facility the base amount prescribed by sub5 section (c)(1) plus the interest (if any) prescribed by sub6 section (c)(2).

7 ‘‘(b) NOTICE OF CHANGE IN STATUS.—The owner of

8 a facility which ceases to be a public or nonprofit school

9 as described in paragraph (1) of subsection (a), or the

10 owner of a facility the use of which changes as described

11 in paragraph (2) or (3) of such subsection shall provide

12 the Secretary written notice of such cessation or change

13 of use within 10 days after the date on which such ces14 sation or change of use occurs or within 30 days after

15 the date of enactment of the Health Professions Training

16 Assistance Act of 1985, whichever is later.

17 ‘‘(c) AMOUNT OF RECOVERY.—

18 ‘‘(1) BASE AMOUNT.—The base amount that

19 the United States is entitled to recover under sub20 section (a) is the amount bearing the same ratio to

21 the then value (as determined by the agreement of

22 the parties or in an action brought in the district

23 court of the United States for the district in which

24 the facility is situated) of the facility as the amount
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1 of the Federal participation bore to the cost of the

2 construction.

3 ‘‘(2) INTEREST.—

4 ‘‘(A) IN GENERAL.—The interest that the

5 United States is entitled to recover under sub6 section (a) is the interest for the period (if any)

7 described in subparagraph (B) at a rate (deter8 mined by the Secretary) based on the average

9 of the bond equivalent rates of 91-day Treasury

10 bills auctioned during such period.

11 ‘‘(B) TIME PERIOD.—The period referred

12 to in subparagraph (A) is the period begin13 ning—

14 ‘‘(i) if notice is provided as prescribed

15 by subsection (b), 191 days after the date

16 on which the owner of the facility ceases to

17 be a public or nonprofit school as described

18 in paragraph (1) of subsection (a), or 191

19 days after the date on which the use of the

20 facility changes as described in paragraph

21 (2) or (3) of such subsection, or

22 ‘‘(ii) if notice is not provided as pre23 scribed by subsection (b), 11 days after the

24 date on which such cessation or change of

25 use occurs,
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1 and ending on the date the amount the United

2 States is entitled to recover if collected.

3 ‘‘(d) WAIVER OF RIGHTS.—The Secretary may waive

4 the recovery rights of the United States under subsection

5 (a)(2) with respect to a facility (under such conditions as

6 the Secretary may establish by regulation) if the Secretary

7 determines that there is good cause for waiving such

8 rights.

9 ‘‘(e) LIMITATION ON LIENS.—The right of recovery

10 of the United States under subsection (a) shall not, prior

11 to judgment, constitute a lien on any facility.

12 ‘‘PART B—NURSE PRACTITIONERS, NURSE MID13 WIVES, AND OTHER ADVANCED PRACTICE

14 NURSES

15 ‘‘SEC. 811. ADVANCED PRACTICE NURSING GRANTS.

16 ‘‘(a) IN GENERAL.—The Secretary may award grants

17 to and enter into contracts with eligible entities to meet

18 the costs of—

19 ‘‘(1) projects that support the enhancement of

20 advanced practice nursing education; and

21 ‘‘(2) traineeships for individuals in advanced

22 practice nursing programs.

23 ‘‘(b) DEFINITION OF ADVANCED PRACTICE

24 NURSES .—For purposes of this section, the term ‘ad25 vanced practice nurses’ means individuals trained in ad-
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1 vanced degree programs, post-nursing master’s certificate

2 programs, or, in the case of nurse midwives or nurse anes3 thetists, in certificate programs that received funding

4 under this title on the date that is one day prior to the

5 date of enactment of this section, to serve as nurse practi6 tioners, nurse midwives, nurse anesthetists, nurse edu7 cators, or public health nurses, or in other nurse special8 ties determined by the secretary to require advanced edu9 cation.

10 ‘‘(c) AUTHORIZED NURSE PRACTITIONER AND

11 NURSE-MIDWIFERY PROGRAMS.—

12 ‘‘(1) IN GENERAL.—Nurse practitioner and

13 nurse midwifery programs eligible for support under

14 this section are educational programs for registered

15 nurses (irrespective of the type of school of nursing

16 in which the nurses received their training) that—

17 ‘‘(A) meet guidelines prescribed by the

18 Secretary in accordance with paragraph (2);

19 and

20 ‘‘(B) have as their objective the education

21 of nurses who will upon completion of their

22 studies in such programs, be qualified to effec23 tively provide primary health care, including

24 primary health care in homes and in ambula-
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1 tory care facilities, long-term care facilities and

2 other health care institutions.

3 ‘‘(2) GUIDELINES.—After consultation with ap4 propriate educational organizations and professional

5 nursing and medical organizations, the Secretary

6 shall prescribe guidelines for programs described in

7 paragraph (1). Such guidelines shall, as a minimum,

8 require that such a program—

9 ‘‘(A) extend for at least one academic year

10 and consist of—

11 ‘‘(i) supervised clinical practice di12 rected toward preparing nurses to deliver

13 primary health care; and

14 ‘‘(ii) at least four months (in the ag15 gregate) of classroom instruction that is so

16 directed; and

17 ‘‘(B) have an enrollment of not less than

18 six full-time equivalent students.

19 ‘‘(d) OTHER AUTHORIZED EDUCATIONAL PRO20 GRAMS.—The Secretary shall prescribe guidelines as ap21 propriate for other advanced practice nurse education pro22 grams eligible for support under this section.

23 ‘‘(e) TRAINEESHIPS.—

24 ‘‘(1) IN GENERAL.—The Secretary may not

25 award a grant to an applicant under subsection (a)
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1 unless the applicant involved agrees that

2 traineeships provided with the grant will pay all or

3 part of the costs of—

4 ‘‘(A) the tuition, books, and fees of the

5 program of advanced nursing practice with re6 spect to which the traineeship is provided; and

7 ‘‘(B) the reasonable living expenses of the

8 individual during the period for which the

9 traineeship is provided.

10 ‘‘(2) DOCTORAL PROGRAMS.—The Secretary

11 may not obligate more than 10 percent of the

12 traineeships under subsection (a) for individuals in

13 doctorate degree programs.

14 ‘‘(3) SPECIAL CONSIDERATION.—In making

15 awards of grants and contracts under subsection

16 (a)(2), the Secretary shall give special consideration

17 to an eligible entity that agrees to expend the award

18 to train advanced practice nurses who will practice

19 in health professional shortage areas designated

20 under section 332.

21 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—

22 ‘‘(1) IN GENERAL.—There are authorized to be

23 appropriated to carry out this section, $50,000,000

24 for fiscal year 1995, and such sums as may be nec25 essary for each of the fiscal years 1996 and 1997.
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1 ‘‘(2) SET ASIDES.—Of the amount appropriated

2 under paragraph (1) for a fiscal year—

3 ‘‘(A) not less than 60 percent of such

4 amount shall be made available for projects to

5 enhance the training and practice of nurse

6 practitioners and nurse midwives; and

7 ‘‘(B) not less than 6 percent of such

8 amounts shall be made available for projects to

9 enhance the training and practice of nurse an10 esthetists.

11 ‘‘PART C—INCREASING NURSING WORKFORCE

12 DIVERSITY

13 ‘‘SEC. 821. WORKFORCE DIVERSITY GRANTS.

14 ‘‘(a) IN GENERAL.—The Secretary may award grants

15 to and enter into contracts with eligible entities to meet

16 the costs of special projects to increase nursing education

17 opportunities for individuals who are from disadvantaged

18 racial and ethnic backgrounds underrepresented among

19 registered nurses by providing student scholarships or sti20 pends, pre-entry preparation, and retention activities.

21 ‘‘(b) GUIDANCE.—In carrying out subsection (a), the

22 Secretary shall take into consideration the recommenda23 tions of the First and Second Invitational Congresses for

24 Minority Nurse Leaders on ‘Caring for the Emerging Ma25 jority,’ in 1992 and 1993, and consult with nursing asso-
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1 ciations including the American Nurses Association, the

2 National League of Nursing, the Association of American

3 Colleges of Nursing, and the Black Nurses Association.

4 ‘‘(c) REQUIRED INFORMATION AND CONDITIONS FOR

5 AWARD RECIPIENTS.—

6 ‘‘(1) IN GENERAL.—Recipients of awards under

7 this section may be required, where requested, to re8 port to the Secretary concerning the annual admis9 sion, retention, and graduation rates for ethnic and

10 racial minorities in the school or schools involved in

11 the projects.

12 ‘‘(2) FALLING RATES.—If any of the rates re13 ported under paragraph (1) fall below the average of

14 the two previous years, the grant or contract recipi15 ent shall provide the Secretary with plans for imme16 diately improving such rates.

17 ‘‘(3) INELIGIBILITY.—A recipient described in

18 paragraph (2) shall be ineligible for continued fund19 ing under this section if the plan of the recipient

20 fails to improve the rates within the 1-year period

21 beginning on the date such plan is implemented.

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

23 are authorized to be appropriated to carry out this section,

24 $5,000,000 for fiscal year 1995, and such sums as may

25 be necessary for each of the fiscal years 1996 and 1997.
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1 ‘‘PART D—STRENGTHENING CAPACITY FOR

2 BASIC NURSE EDUCATION AND PRACTICE

3 ‘‘SEC. 831. BASIC NURSE EDUCATION AND PRACTICE

4 GRANTS.

5 ‘‘(a) IN GENERAL.—The Secretary may award grants

6 to and enter into contracts with eligible entities for

7 projects to strengthen capacity for basic nurse education

8 and practice.

9 ‘‘(b) PRIORITY AREAS.—In awarding grants or con10 tracts under this section the Secretary shall give priority

11 to entities that will use amounts provided under such a

12 grant or contract to enhance the education mix and utili13 zation of the basic nursing workforce by strengthening

14 programs that provide basic nurse education for purposes

15 of—

16 ‘‘(1) improving nursing services in schools and

17 other community settings;

18 ‘‘(2) providing care for underserved populations

19 and other high-risk groups such as the elderly, indi20 viduals with HIV-AIDS, substance abusers, home21 less, and battered women;

22 ‘‘(3) providing case management, quality im23 provement, delegation and supervision, other skills

24 needed under new health care systems;
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1 ‘‘(4) developing cultural competencies among

2 nurses;

3 ‘‘(5) providing emergency health services;

4 ‘‘(6) promoting career mobility for nursing per5 sonnel in a variety of training settings cross training

6 or specialty training, and among diverse population

7 groups; or

8 ‘‘(7) other priority areas as determined by the

9 Secretary.

10 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There

11 are authorized to be appropriated to carry out this section,

12 $12,000,000 for fiscal year 1995, and such sums as may

13 be necessary for each of the fiscal years 1996 and 1997.’’;

14 and

15 (7) by redesignating section 855 as section 808,

16 and transferring such section so as to appear after

17 section 807 (as added by the amendment made by

18 paragraph (7)).

19 SEC. 4. SAVINGS PROVISION AND TECHNICAL AMEND20 MENTS.

21 (a) SAVINGS PROVISION.—In the case of any author22 ity for making awards of grants or contracts that is termi23 nated by the amendment made by section 3, the Secretary

24 of Health and Human Services may, notwithstanding the

25 termination of the authority, continue in effect any grant
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1 or contract made under the authority that is in effect on

2 the day before the date of the enactment of this Act, sub3 ject to the duration of any such grant or contract not ex4 ceeding the period determined by the Secretary in first

5 approving such financial assistance, or in approving the

6 most recent request made (before the date of such enact7 ment) for continuation of such assistance, as the case may

8 be.

9 (b) CLINICAL RESEARCHERS.—Paragraph (3) of sec10 tion 487E(a) of the Public Health Service Act (42 U.S.C.

11 288–5(a)(3)) is amended to read as follows:

12 ‘‘(3) APPLICABILITY OF CERTAIN PROVISIONS

13 REGARDING OBLIGATED SERVICE.—With respect to

14 the National Health Service Corps loan repayment

15 program established in subpart III of part D of title

16 III, the provisions of such subpart shall, except as

17 inconsistent with this section, apply to the program

18 established in subsection (a) in the same manner

19 and to the same extent as such provisions apply to

20 the National Health Service Corps loan repayment

21 programs.’’.

22 (c) TECHNICAL AMENDMENTS.—Section 839 of such

23 Act (42 U.S.C. 297e) is amended—

24 (1) in subsection (a)—
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1 (A) by striking the matter preceding para2 graph (1) and inserting the following:

3 ‘‘(a) If a school terminates a loan fund established

4 under an agreement pursuant to section 835(b), or if the

5 Secretary for good cause terminates the agreement with

6 the school, there shall be a capital distribution as fol7 lows:’’; and

8 (B) in paragraph (1), by striking ‘‘at the

9 close of September 30, 1999,’’ and inserting

10 ‘‘on the date of termination of the fund’’; and

11 (2) in subsection (b), to read as follows:

12 ‘‘(b) If a capital distribution is made under sub13 section (a), the school involved shall, after such capital dis14 tribution, pay to the Secretary, not less often than quar15 terly, the same proportionate share of amounts received

16 by the school in payment of principal or interest on loans

17 made from the loan fund established under section 835(b)

18 as determined by the Secretary under subsection (a).’’.

19 SEC. 5. EFFECTIVE DATE.

20 This Act shall take effect on October 1, 1994, or the

21 date of enactment of this Act, whichever is later.

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S 2433 IS——2