IIB 

115TH CONGRESS 

2D SESSION H. R. 959 

IN THE SENATE OF THE UNITED STATES 

JULY 24, 2018 

Received; read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

AN ACT 

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, 


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1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

3 ‘‘Title VIII Nursing Workforce Reauthorization Act of 

4 2018’’. 

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

6 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. 

7 SEC. 2. GENERAL PROVISIONS. 

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

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

10 striking ‘‘shall address relevant national nursing needs 

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

12 relevant national nursing needs that the project will ad13 dress and how the project aligns with the national nursing 

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

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

16 Health Service Act (42 U.S.C. 296b) is amended by add17 ing at the end the following: 

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

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

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


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1 funds that would otherwise be made available for such 

2 project or activity.’’. 

3 (c) GENERALLY APPLICABLE PROVISIONS.—Section 

4 806 of the Public Health Service Act (42 U.S.C. 296e) 

5 is amended— 

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

7 (2) to read as follows: 

8 ‘‘(2) EVALUATIONS.—The Secretary shall es9 tablish procedures to ensure the annual evaluation of 

10 programs and projects operated by recipients of 

11 grants under this title. Such procedures shall ensure 

12 that continued funding for such programs and 

13 projects will be conditioned upon the submission 

14 of— 

15 ‘‘(A) data demonstrating that satisfactory 

16 progress has been made by the program or 

17 project in meeting the performance outcome 

18 standards (as described in section 802) of such 

19 program or project; and 

20 ‘‘(B) a detailed description of activities 

21 conducted by such program or project to meet 

22 such performance outcome standards.’’; 

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

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


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1 are not officers or employees of the Federal Govern2 ment’’; and 

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

4 ‘‘(i) ANNUAL REPORT ON NURSING WORKFORCE

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

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

7 the Senate, and the Committee on Energy and Commerce 

8 of the House of Representatives, a report containing an 

9 assessment of the programs and activities of the Depart10 ment of Health and Human Services related to enhancing 

11 the nursing workforce, including the extent to which pro12 grams and activities under this title meet identified goals 

13 and performance measures developed for the respective 

14 programs and activities.’’. 

15 SEC. 3. NURSE PRACTITIONERS, NURSE MIDWIVES, NURSE 

16 ANESTHETISTS, AND OTHER ADVANCED EDU17 CATION NURSES. 

18 Section 811 of the Public Health Service Act (42 

19 U.S.C. 296j) is amended— 

20 (1) in subsection (b)— 

21 (A) by striking ‘‘R.N./Master’s’’ and in22 serting ‘‘R.N./graduate’’; and 

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

24 before ‘‘or public health nurses’’; 


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

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

3 (3) by inserting after subsection (e) the fol4 lowing new subsection: 

5 ‘‘(f) AUTHORIZED CLINICAL NURSE SPECIALIST

6 PROGRAMS.—Clinical nurse specialist programs eligible 

7 for support under this section are education programs 

8 that— 

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

10 clinical nurse specialist education; and 

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

12 clinical nurse specialists who will upon completion of 

13 such a program be qualified to effectively provide 

14 care through the wellness and illness continuum to 

15 inpatients and outpatients experiencing acute and 

16 chronic illness.’’; and 

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

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

19 are authorized to be appropriated to carry out this section 

20 $74,581,000 for each of fiscal years 2019 through 2023.’’. 

21 SEC. 4. INCREASING NURSING WORKFORCE DIVERSITY. 

22 Section 821 of the Public Health Service Act (42 

23 U.S.C. 296m) is amended by adding at the end the fol24 lowing: 


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

2 are authorized to be appropriated to carry out this section 

3 $17,343,000 for each of fiscal years 2019 through 2023.’’. 

4 SEC. 5. STRENGTHENING CAPACITY FOR BASIC NURSE 

5 EDUCATION AND PRACTICE. 

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

7 RETENTION GRANTS.—Section 831 of the Public Health 

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

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

10 QUALITY’’ and inserting ‘‘QUALITY, AND RETEN11 TION’’; 

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

13 (2) to read as follows: 

14 ‘‘(2) providing care for underserved populations 

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

16 individuals with HIV/AIDS, individuals with mental 

17 health or substance use disorders, individuals who 

18 are homeless, and victims and survivors of domestic 

19 violence;’’; 

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

21 (1) to read as follows: 

22 ‘‘(1) GRANTS FOR CAREER LADDER PRO23 GRAMS.—The Secretary may award grants to and 

24 enter into contracts with eligible entities for pro25 grams— 


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

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

3 training settings, cross training or spe4 cialty training among diverse population 

5 groups, and the advancement of individ6 uals, including to become professional reg7 istered nurses, advanced practice reg8 istered nurses, and nurses with graduate 

9 nursing education; and 

10 ‘‘(ii) individuals, including licensed 

11 practical nurses, licensed vocational nurses, 

12 certified nurse assistants, and diploma de13 gree or associate degree nurses, to become 

14 baccalaureate-prepared registered nurses 

15 or nurses with graduate nursing education; 

16 ‘‘(B) to assist individuals in obtaining edu17 cation and training required to enter the nurs18 ing profession and advance within such profes19 sion, such as by providing career counseling and 

20 mentoring; and 

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

22 accredited fellowships, and accredited residency 

23 programs in collaboration with one or more ac24 credited schools of nursing to encourage men25 toring and development of specialties.’’; 


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1 (4) by striking subsection (e) (relating to pref2 erence); 

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

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

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

6 striking ‘‘The Secretary shall submit to the Congress 

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

8 ‘‘As part of the report on nursing workforce pro9 grams described in section 806(i), the Secretary 

10 shall’’; 

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

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

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

14 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en15 tity’ includes an accredited school of nursing, a 

16 health care facility, a partnership of such a school 

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

18 nurse-managed health clinic. 

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

20 term ‘nurse-managed health clinic’ means a nurse21 practice arrangement, managed by advanced practice 

22 nurses, that provides primary care or wellness serv23 ices to underserved or vulnerable populations that is 

24 associated with a school, college, university or de25 partment of nursing, federally qualified health cenVerDate Sep 11 2014 02:49 Jul 25, 2018 Jkt 079200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H959.RFS H959

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1 ter, or independent nonprofit health or social serv2 ices agency.’’; and 

3 (8) in subsection (g), as redesignated by para4 graph (5), by striking ‘‘such sums as may be nec5 essary for each of fiscal years 2010 through 2014’’ 

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

7 2019 through 2023’’. 

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

9 the Public Health Service Act (42 U.S.C. 296p–1) is re10 pealed. 

11 SEC. 6. STUDENT LOANS. 

12 (a) LOAN REPAYMENT AND SCHOLARSHIP PRO13 GRAMS.—Section 846 of the Public Health Service Act (42 

14 U.S.C. 297n) is amended— 

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

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

17 such practice’’; 

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

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

20 thereafter)’’; 

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

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

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

24 nursing workforce programs, as required by section 

25 806(i), shall include information regarding the proVerDate Sep 11 2014 02:49 Jul 25, 2018 Jkt 079200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H959.RFS H959

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1 grams carried out under this section, including’’; 

2 and 

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

4 as may be necessary for each of fiscal years 2003 

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

6 of fiscal years 2019 through 2023’’. 

7 (b) NURSE FACULTY LOAN PROGRAM.—Section 

8 846A of the Public Health Service Act (42 U.S.C. 297n– 

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

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

11 ‘‘$28,500,000 for each of fiscal years 2019 through 

12 2023’’. 

13 SEC. 7. NATIONAL ADVISORY COUNCIL ON NURSE EDU14 CATION AND PRACTICE. 

15 Section 851 of the Public Health Service Act (42 

16 U.S.C. 297t) is amended— 

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

18 nurse anesthetists’’ and inserting ‘‘nurse anes19 thetists, and clinical nurse specialists’’; 

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

21 (3) to read as follows: 

22 ‘‘(3) not later than 2 years after the date of en23 actment of the Title VIII Nursing Workforce Reau24 thorization Act of 2018, and every 2 years there25 after, prepare and submit to the Secretary, the ComVerDate Sep 11 2014 02:49 Jul 25, 2018 Jkt 079200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H959.RFS H959

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1 mittee on Health, Education, Labor, and Pensions 

2 of the Senate, and the Committee on Energy and 

3 Commerce of the House of Representatives, a report 

4 describing the activities of the Council, including 

5 findings and recommendations made by the Council 

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

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

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

9 and D of this title’’. 

10 SEC. 8. OTHER PROVISIONS. 

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

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

13 297w et seq.) is repealed. 

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

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

Passed the House of Representatives July 23, 2018. 

Attest: KAREN L. HAAS, 

Clerk. 


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