II 

110TH CONGRESS 

1ST SESSION S. 1604 

To increase the number of well-educated nurses, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 13, 2007 

Mrs. CLINTON (for herself and Mr. SMITH) introduced the following bill; which 

was read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

A BILL 

To increase the number of well-educated nurses, 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 and Quality of Health Care Act of 2007’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) The current nursing workforce is the largest 

9 group of healthcare providers in the United States. 


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1 (2) There will be a need for 1,200,000 new and 

2 replacement nurses by 2014. 

3 (3) Over 38,000 qualified applicants were 

4 turned away from entry-level nursing programs lead5 ing to a baccalaureate degree in 2006. This number 

6 increases to 147,000 when all schools of nursing are 

7 taken into account. 

8 (4) Insufficient numbers of faculty is the pri9 mary reason given by schools of nursing for not ac10 cepting qualified applicants. 

11 (5) The average age of doctorally-prepared 

12 nurse faculty is almost 56 years old. 

13 (6) Nurses are the healthcare providers most 

14 likely to intercept medication errors before the errors 

15 reach patients and result in adverse events. 

16 (7) Employing a greater proportion of more 

17 highly educated nurses may reduce the rates of pa18 tient mortality. 

19 SEC. 3. RURAL NURSES TRAINING GRANT PROGRAM. 

20 Part D of title VIII of the Public Health Service Act 

21 (42 U.S.C. 296p) is amended by adding at the end the 

22 following: 

23 ‘‘SEC. 832. RURAL NURSES TRAINING GRANT PROGRAM. 

24 ‘‘(a) IN GENERAL.—The Secretary shall award 

25 grants to, or enter into contracts with, eligible entities for 


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1 the purpose of educating nurses to serve in rural areas 

2 and areas of nurse specialty shortage. 

3 ‘‘(b) USE OF FUNDS.—An eligible entity that receives 

4 a grant under this section shall use grant funds to develop 

5 distance learning education by— 

6 ‘‘(1) providing technology infrastructure to en7 hance or increase— 

8 ‘‘(A) broadband connectivity; and 

9 ‘‘(B) education rooms wired for the Inter10 net; 

11 ‘‘(2) providing technology infrastructure for a 

12 video conferencing network; 

13 ‘‘(3) recruiting, training, and supporting com14 munity-based faculty for classroom and clinical 

15 training; or 

16 ‘‘(4) recruiting and supporting community17 based sites for clinical training. 

18 ‘‘(c) ANALYSES.—Not later than 1 year after the Sec19 retary awards grants under subsection (a), and annually 

20 thereafter, the Secretary, working with the Administrator 

21 of the Health Resources and Services Administration and 

22 appropriate nursing agencies, shall collect and perform 

23 analyses on the number of nurses in the United States 

24 to track rural nursing trends. 


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1 ‘‘(d) REPORT.—Not later than 2 years after the date 

2 of enactment of this Act, the Secretary shall generate an 

3 annual report about the status of the nursing workforce 

4 in the United States and shall disseminate the report as 

5 the Secretary determines appropriate. 

6 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

7 are authorized to be appropriated to carry out this section 

8 such sums as may be necessary for each of the fiscal years 

9 2008 through 2012.’’. 

10 SEC. 4. NURSE FACULTY DEVELOPMENT. 

11 (a) NURSE FACULTY DEVELOPMENT PROGRAM.— 

12 Part D of title VIII of the Public Health Service Act (42 

13 U.S.C. 296p et seq.) is amended by inserting after section 

14 832 (as added by section 3) the following: 

15 ‘‘SEC. 833. NURSE FACULTY DEVELOPMENT PROGRAM. 

16 ‘‘(a) IN GENERAL.—The Secretary, acting through 

17 the Administrator of the Health Resources and Services 

18 Administration, shall award grants to eligible entities for 

19 the establishment and operation of demonstration projects 

20 that will expand the numbers of nurse faculty within 

21 schools of nursing, including— 

22 ‘‘(1) developing recruitment programs for 

23 nurses with academic credentials for faculty status 

24 who are not teaching at the time; 


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1 ‘‘(2) offering scholarships that facilitate the re2 turn of registered nurses to a school of nursing on 

3 a part-time basis for graduate education that leads 

4 to a career in nursing education; 

5 ‘‘(3) providing additional education to enable 

6 nurses with graduate degrees to serve as faculty by 

7 obtaining teaching certificates; 

8 ‘‘(4) developing accelerated doctoral programs 

9 that will facilitate entry in a nursing faculty posi10 tion; 

11 ‘‘(5) developing online continuing education 

12 courses and practice teaching opportunities for nurse 

13 faculty; and 

14 ‘‘(6) developing research internships and fellow15 ships for nursing students at academic medical cen16 ters to foster interest in academic research. 

17 ‘‘(b) REPORT.—Not later than 2 years after the date 

18 of enactment of the Nursing Education and Quality of 

19 Health Care Act of 2007, the Comptroller General of the 

20 United States shall prepare and submit a report to Con21 gress that— 

22 ‘‘(1) addresses the causes of the nurse faculty 

23 shortage; and 


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1 ‘‘(2) makes recommendations to increase the 

2 numbers and the retention of nurse faculty mem3 bers. 

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

5 are authorized to be appropriated to carry out this section 

6 such sums as may be necessary for each of the fiscal years 

7 2008 through 2012.’’. 

8 (b) DOCTORAL PROGRAMS.—Section 811(f)(2) of the 

9 Public Health Service Act (42 U.S.C. 296j(f)(2)) is 

10 amended by striking the period at the end and inserting 

11 ‘‘, except that in the case of a nurse faculty shortage, the 

12 Secretary may, in the Secretary’s discretion, obligate more 

13 than 10 percent of such traineeships for individuals in doc14 toral degree programs.’’. 

15 SEC. 5. DEVELOPING THE RURAL NURSING WORKFORCE. 

16 Part C of title VIII of the Public Health Service Act 

17 (42 U.S.C. 296m) is amended by adding at the end the 

18 following: 

19 ‘‘SEC. 822. DEVELOPING THE RURAL NURSING WORK20 FORCE. 

21 ‘‘(a) IN GENERAL.—The Secretary shall award 

22 grants to, and enter into contracts with, eligible entities 

23 to increase the nursing opportunities for individuals who 

24 reside in rural communities. The activities funded under 

25 this section shall include— 


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1 ‘‘(1) increasing and expanding pipeline pro2 grams, including— 

3 ‘‘(A) mathematics and science programs; 

4 ‘‘(B) Nurse Medical Academy of Science 

5 and Health (MASH) Camp and other health ca6 reer pipeline programs for middle school and 

7 secondary school students tied to higher edu8 cation curricula; 

9 ‘‘(C) nurse mentor programs that provide 

10 experience for secondary school students in clin11 ical settings to learn about the nursing profes12 sion; 

13 ‘‘(D) training for middle school and sec14 ondary school guidance counselors; and 

15 ‘‘(E) programs that attract nontraditional 

16 nursing students, including minorities and men; 

17 ‘‘(2) supporting a web-based healthcare work18 force development system that will be a database19 driven website to connect employers, educators, rural 

20 communities, and students with the nursing pipeline 

21 and recruitment programs described in this section; 

22 and 

23 ‘‘(3) increasing the program capacity of acceler24 ated registered nurse programs that recruit individ25 uals with baccalaureate degrees in other fields into 


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1 baccalaureate or graduate degree nursing programs 

2 that serve rural communities, by— 

3 ‘‘(A) increasing the number of faculty; 

4 ‘‘(B) increasing clinical training sites; and 

5 ‘‘(C) providing financial incentives, includ6 ing loan forgiveness and tuition assistance for 

7 nurses who practice in rural areas. 

8 ‘‘(b) AWARD BASIS.— 

9 ‘‘(1) AWARD BASIS FOR FIRST 2 YEARS.—For 

10 each of the first 2 fiscal years for which funds are 

11 appropriated under subsection (c), the Secretary 

12 shall, to the extent practicable— 

13 ‘‘(A) use 80 percent of such funds to 

14 award grants under this section to carry out the 

15 activity described in subsection (a)(3); and 

16 ‘‘(B) use 20 percent of such funds to 

17 award grants under this section to carry out the 

18 activities described in paragraphs (1) and (2) of 

19 subsection (a). 

20 ‘‘(2) AWARD BASIS FOR SUBSEQUENT YEARS.— 

21 For each fiscal year following the first 2 fiscal years 

22 for which funds are appropriated under subsection 

23 (c), the Secretary shall, in awarding grants under 

24 this section, arrange for such distribution of funds 

25 and grants to carry out the various activities deVerDate Aug 31 2005 22:07 Jun 14, 2007 Jkt 059200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1604.IS S1604

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1 scribed in subsection (a) as the Secretary determines 

2 appropriate. 

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

4 are authorized to be appropriated to carry out this section 

5 such sums as may be necessary for each of the fiscal years 

6 2008 through 2012.’’. 

7 SEC. 6. NURSING AND THE QUALITY OF HEALTHCARE. 

8 Title VIII of the Public Health Service Act (42 

9 U.S.C. 296 et seq.) is amended by adding at the end the 

10 following: 

11 ‘‘PART J—NURSING AND IMPROVING 

12 HEALTHCARE 

13 ‘‘SEC. 861. LINKING NURSING EDUCATION AND QUALITY 

14 OUTCOMES PROGRAM. 

15 ‘‘(a) IN GENERAL.—The Secretary, in collaboration 

16 with the Administrator of the Health Resources and Serv17 ices Administration and the Director of the Agency for 

18 Healthcare Research and Quality, shall award grants to 

19 entities that meet the requirements of subsection (b) to 

20 enable the entities to carry out demonstration projects 

21 that advance the education, delivery, or measurement of 

22 quality and patient safety in nursing practice. 

23 ‘‘(b) ELIGIBILITY.—To be eligible to receive a dem24 onstration project grant under this section, an entity 

25 shall— 


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1 ‘‘(1) be a school of nursing, a nursing center, 

2 an academic health center, a State or local govern3 ment, or any other public or private nonprofit entity 

4 determined appropriate by the Secretary; 

5 ‘‘(2) submit to the Secretary an application in 

6 accordance with section 802; 

7 ‘‘(3) form a partnership with 1 or more eligible 

8 entities; and 

9 ‘‘(4) submit a plan to the Secretary that 

10 assures grant funds received under this section will 

11 be used to support the implementation and evalua12 tion of healthcare quality improvement activities that 

13 include— 

14 ‘‘(A) with respect to healthcare systems, 

15 activities relating to improving patient safety, 

16 timeliness of care, effectiveness of care, equity 

17 and efficiency of care, and patient-centeredness; 

18 or 

19 ‘‘(B) with respect to patients, activities, in20 cluding activities relating to staying healthy, 

21 getting well, living with illness or disability, and 

22 coping with end of life issues. 

23 ‘‘(c) PRIORITY.—In awarding grants under sub24 section (a), the Secretary shall give priority to entities that 

25 will carry out 1 or more of the following: 


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1 ‘‘(1) IMPLEMENTATION.—Implementing initia2 tives in professional nursing education to enhance 

3 patient safety efforts through evidence-based prac4 tice and quality improvement strategies by— 

5 ‘‘(A) developing partnerships between ac6 credited schools of nursing and health care fa7 cilities, as defined in section 801, to educate 

8 registered nurses in clinical leadership, inter9 disciplinary team management, systems admin10 istration, outcomes and risk management, and 

11 education, for implementation in multiple 

12 healthcare settings; and 

13 ‘‘(B) providing scholarships for registered 

14 professional nurses to pursue advanced nursing 

15 education in accordance with subsection (a). 

16 ‘‘(2) EDUCATION.—Integrating quality and 

17 safety competencies into nursing education programs 

18 by— 

19 ‘‘(A) disseminating patient safety edu20 cation content to a nurse faculty administrator 

21 to integrate quality competencies into each 

22 school of nursing that are consistent with tech23 nical standards that are developed or adopted 

24 by voluntary consensus standards bodies under 

25 section 12(d) of the National Technology 


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1 Transfer and Advancement Act of 1995 (15 

2 U.S.C. 272 note); and 

3 ‘‘(B) developing ongoing web-based mod4 ules for continued nurse faculty education to 

5 bring research evidence into practice not later 

6 than 2 years after receiving a grant under this 

7 section; and 

8 ‘‘(3) provide continuing education for practicing 

9 nurses, including— 

10 ‘‘(A) developing web-based modules related 

11 to patient safety, including topics of evidenced12 based practice, professional communication, pa13 tient or family-centered care, systems thinking, 

14 informatics, collaborative practice, medication, 

15 and practice error; and 

16 ‘‘(B) developing systems for the dissemina17 tion of continuing education through facility18 based staff development and orientation. 

19 ‘‘(d) EVALUATION.—The Secretary shall award 

20 grants to entities described in subsection (b) to collect 

21 data and study the potential benefits of basic and ad22 vanced nursing education levels or certification status in 

23 the efforts to promote quality improvement strategies and 

24 enhance patient outcomes and cost saving measures, by— 


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1 ‘‘(1) compiling and analyzing quality indicator 

2 data from existing databases and other sources to 

3 evaluate relationships between basic and advanced 

4 nursing education levels or certification status on 

5 nursing sensitive indicators and quality outcomes; 

6 ‘‘(2) working in consultation with State depart7 ments of health or other nonprofit patient safety or8 ganizations; or 

9 ‘‘(3) demonstrating the cost savings and sus10 tainability of the demonstration projects. 

11 ‘‘(e) REPORT.—Not later than 2 years after the date 

12 of enactment of the Nursing Education and Quality of 

13 Health Care Act of 2007, the Secretary shall submit a 

14 report to Congress on the results of the program under 

15 this section. 

16 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

17 are authorized to be appropriated to carry out this section 

18 such sums as may be necessary for each of the fiscal years 

19 2008 through 2012.’’. 

Æ 


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