I 

109TH CONGRESS 

1ST SESSION H. R. 2184 

To provide for a study by the Institute of Medicine of the National Academy 

of Sciences to identify constraints encountered by schools of nursing 

in admitting and graduating the number of nurses sufficient to meet 

the health care needs of the United States, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 5, 2005 

Mr. HOLT introduced the following bill; which was referred to the Committee 

on Energy and Commerce 

A BILL 

To provide for a study by the Institute of Medicine of the 

National Academy of Sciences to identify constraints encountered by schools of nursing in admitting and graduating the number of nurses sufficient to meet the health 

care needs of 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 ‘‘Nursing School Capac5 ity Act of 2005’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds as follows: 
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1 (1) Researchers in the field of public health 

2 have identified the need for a national study to iden3 tify constraints encountered by schools of nursing in 

4 graduating the number of nurses sufficient to meet 

5 the health care needs of the United States. 

6 (2) The shortage of qualified registered nurses 

7 has adversely affected the health care system of the 

8 United States. 

9 (3) Individual States have had varying degrees 

10 of success with programs designed to increase the 

11 recruitment and retention of nurses. 

12 (4) Schools of nursing have been unable to pro13 vide a sufficient number of qualified graduates to 

14 meet the workforce needs. 

15 (5) Many nurses are approaching the age of re16 tirement, and the problem worsens each year. 

17 (6) In 2004, an estimated 125,000 applications 

18 from qualified applicants were rejected by schools of 

19 nursing, due to a shortage of faculty and a lack of 

20 capacity for additional students. 

21 SEC. 3. STUDY WITH RESPECT TO CONSTRAINTS WITH RE22 SPECT TO SCHOOLS OF NURSING. 

23 (a) IN GENERAL.—The Secretary of Health and 

24 Human Services shall request the Institute of Medicine 

25 of the National Academy of Sciences to enter into an 
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1 agreement under which the Institute conducts a study for 

2 the purpose of— 

3 (1) identifying constraints encountered by 

4 schools of nursing in admitting and graduating the 

5 number of registered nurses necessary to ensure pa6 tient safety and meet the need for quality assurance 

7 in the provision of health care; and 

8 (2) developing recommendations to alleviate the 

9 constraints on a short-term and long-term basis. 

10 (b) CERTAIN COMPONENTS.—The Secretary shall en11 sure that the agreement under subsection (a) provides 

12 that the study under such subsection will include informa13 tion on the following: 

14 (1) The trends in applications for attendance at 

15 schools of nursing that are relevant to the purpose 

16 described in such subsection, including trends re17 garding applicants who are accepted for enrollment 

18 and applicants who are not accepted, particularly 

19 qualified applicants who are not accepted. 

20 (2) The number and demographic characteris21 tics of entry-level and graduate students currently 

22 enrolled in schools of nursing, the retention rates at 

23 the schools, and the number of recent graduates 

24 from the schools, as compared to previous years and 
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1 to the projected need for registered nurses based on 

2 two-year, five-year, and ten-year projections. 

3 (3) The number and demographic characteris4 tics of nurses who pursue graduate education in 

5 nursing and non-nursing programs but do not pur6 sue faculty positions in schools of nursing, the rea7 sons therefor, including any regulatory barriers to 

8 choosing to pursue such positions, and the effect of 

9 such decisions on the ability of the schools to obtain 

10 adequate numbers of faculty members. 

11 (4) The extent to which entry-level graduates of 

12 the schools are satisfied with their educational prep13 aration, including their participation in nurse 

14 externships, internships, and residency programs, 

15 and to which they are able to effectively transition 

16 into the nursing workforce. 

17 (5) The satisfaction of nurse managers and ad18 ministrators with respect to the preparation and per19 formance levels of entry-level graduates from the 

20 schools after one-year, three-year, and five-years of 

21 practice, respectively. 

22 (6) The extent to which the current salary, ben23 efit structures, and characteristics of the workplace, 

24 including the number of nurses who are presently 
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1 serving in faculty positions, influence the career path 

2 of nurses who have pursued graduate education. 

3 (7) The extent to which the use of innovative 

4 technologies for didactic and clinical nursing edu5 cation might provide for an increase in the ability of 

6 schools of nursing to train qualified nurses. 

7 (c) RECOMMENDATIONS.—Recommendations under 

8 subsection (a)(2) may include recommendations for legis9 lative or administrative changes at the Federal or State 

10 level, and measures that can be taken in the private sec11 tor— 

12 (1) to facilitate the recruitment of students into 

13 the nursing profession; 

14 (2) to facilitate the retention of nurses in the 

15 workplace; and 

16 (3) to improve the resources and ability of the 

17 education and health care systems to prepare a suf18 ficient number of qualified registered nurses. 

19 (d) METHODOLOGY OF STUDY.— 

20 (1) SCOPE.—The Secretary shall ensure that 

21 the agreement under subsection (a) provides that the 

22 study under such subsection will consider the per23 spectives of nurses and physicians in each of the 

24 various types of inpatient, outpatient, and residential 

25 facilities in the health care delivery system; faculty 
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1 and administrators of schools of nursing; providers 

2 of health plans or health insurance; and consumers. 

3 (2) CONSULTATION WITH RELEVANT ORGANIZA4 TION.—The Secretary shall ensure that the agree5 ment under subsection (a) provides that relevant 

6 agencies and organizations with expertise on the 

7 nursing shortage will be consulted with respect to 

8 the study under such subsection, including but not 

9 limited to the following: 

10 (A) The Agency for Healthcare Research 

11 and Quality. 

12 (B) The American Academy of Nursing. 

13 (C) The American Association of Colleges 

14 of Nursing. 

15 (D) The American Nurses Association. 

16 (E) The American Organization of Nurse 

17 Executives. 

18 (F) The National Institute of Nursing Re19 search. 

20 (G) The National League for Nursing. 

21 (H) The National Organization for Asso22 ciate Degree Nursing. 

23 (I) The National Student Nurses Associa24 tion. 
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1 (e) REPORT.—The Secretary shall ensure that the 

2 agreement under subsection (a) provides that not later 

3 than 18 months after the date of the enactment of this 

4 Act, a report providing the findings and recommendations 

5 made in the study under such subsection will be submitted 

6 to the Secretary, the Committee on Energy and Commerce 

7 of the House of Representatives, and the Committee on 

8 Health, Labor, Education, and Pensions of the Senate. 

9 (f) OTHER ORGANIZATION.—If the Institute declines 

10 to conduct the study under subsection (a), the Secretary 

11 may enter into an agreement with another appropriate pri12 vate entity to conduct the study. 

13 (g) AUTHORIZATION OF APPROPRIATIONS.—There 

14 are authorized to be appropriated such sums as may be 

15 necessary to carry out this section. 

16 SEC. 4. DEFINITIONS. 

17 For purposes of this Act: 

18 (1) The term ‘‘Institute’’ means the Institute of 

19 Medicine of the National Academy of Sciences. 

20 (2)(A) The term ‘‘school of nursing’’ means a 

21 collegiate, associate degree, or diploma school of 

22 nursing in a State. 

23 (B) The terms ‘‘collegiate school of nursing’’, 

24 ‘‘associate degree school of nursing’’, and ‘‘diploma 

25 school of nursing’’ have the meanings given to such 
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1 terms in section 801 of the Public Health Service 

2 Act. 

3 (3) The term ‘‘Secretary’’ means the Secretary 

4 of Health and Human Services. 

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