II 

109TH CONGRESS 

2D SESSION S. 4029 

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

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 29, 2006 

Mrs. CLINTON 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 2006’’. 

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. 

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

11 replacement nurses by 2014. 


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1 (3) Over 37,000 qualified applicants were 

2 turned away from entry-level nursing programs lead3 ing to a baccalaureate degree in 2005. This number 

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

5 taken into account. 

6 (4) Insufficient numbers of faculty is the pri7 mary reason given by schools of nursing for not ac8 cepting qualified applicants. 

9 (5) The average age of doctorally-prepared 

10 nurse faculty is almost 56 years old. 

11 (6) Nurses are the healthcare providers most 

12 likely to intercept medication errors before the errors 

13 reach patients and result in adverse events. 

14 (7) Employing a greater proportion of more 

15 highly educated nurses may reduce the rates of pa16 tient mortality. 

17 SEC. 3. RURAL NURSES TRAINING GRANT PROGRAM. 

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

19 (42 U.S.C. 296p) is amended by adding at the end the 

20 following: 

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

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

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

24 the purpose of educating nurses to serve in rural areas. 


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

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

3 distance learning education by— 

4 ‘‘(1) providing technology infrastructure to en5 hance or increase— 

6 ‘‘(A) broadband connectivity; and 

7 ‘‘(B) education rooms wired for the Inter8 net; 

9 ‘‘(2) providing technology infrastructure for a 

10 video conferencing network; 

11 ‘‘(3) recruiting, training, and supporting com12 munity-based faculty for classroom and clinical 

13 training; or 

14 ‘‘(4) recruiting and supporting community15 based sites for clinical training. 

16 ‘‘(c) ANALYSES.—Not later than 1 year after the Sec17 retary awards grants under subsection (a), and annually 

18 thereafter, the Secretary, working with the Administrator 

19 of the Health Resources and Services Administration and 

20 appropriate nursing agencies, shall collect and perform 

21 analyses on the number of nurses in the United States 

22 to track rural nursing trends. 

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

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

25 annual report about the status of the nursing workforce 


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1 in the United States and shall disseminate the report as 

2 the Secretary determines appropriate. 

3 ‘‘(e) 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 2007 through 2011.’’. 

7 SEC. 4. NURSE FACULTY DEVELOPMENT. 

8 (a) NURSE FACULTY DEVELOPMENT PROGRAM.— 

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

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

11 832 (as added by section 3) the following: 

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

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

14 the Administrator of the Health Resources and Services 

15 Administration, shall award grants to eligible entities for 

16 the establishment and operation of demonstration projects 

17 that will expand the numbers of nurse faculty within 

18 schools of nursing, including— 

19 ‘‘(1) developing recruitment programs for 

20 nurses with academic credentials for faculty status 

21 who are not teaching at the time; 

22 ‘‘(2) offering scholarships that facilitate the re23 turn of registered nurses to a school of nursing on 

24 a part-time basis for graduate education that leads 

25 to a career in nursing education; 


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1 ‘‘(3) providing additional education to enable 

2 nurses with graduate degrees to serve as faculty by 

3 obtaining teaching certificates; 

4 ‘‘(4) developing accelerated doctoral programs 

5 that will facilitate entry in a nursing faculty posi6 tion; 

7 ‘‘(5) developing online continuing education 

8 courses and practice teaching opportunities for nurse 

9 faculty; and 

10 ‘‘(6) developing research internships and fellow11 ships for nursing students at academic medical cen12 ters to foster interest in academic research. 

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

14 of enactment of the Nursing Education and Quality of 

15 Health Care Act of 2006, the Comptroller General of the 

16 United States shall prepare and submit a report to Con17 gress that— 

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

19 shortage; and 

20 ‘‘(2) makes recommendations to increase the 

21 numbers and the retention of nurse faculty mem22 bers. 

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

24 are authorized to be appropriated to carry out this section 


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

2 2007 through 2011.’’. 

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

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

5 amended by striking the period at the end and inserting 

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

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

8 than 10 percent of such traineeships for individuals in doc9 toral degree programs.’’. 

10 SEC. 5. DEVELOPING THE RURAL NURSING WORKFORCE. 

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

12 (42 U.S.C. 296m) is amended by adding at the end the 

13 following: 

14 ‘‘SEC. 822. DEVELOPING THE RURAL NURSING WORK15 FORCE. 

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

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

18 to increase the nursing opportunities for individuals who 

19 reside in rural communities. The activities funded under 

20 this section shall include— 

21 ‘‘(1) increasing and expanding pipeline pro22 grams, including— 

23 ‘‘(A) mathematics and science programs; 

24 ‘‘(B) Nurse Medical Academy of Science 

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1 reer pipeline programs for middle school and 

2 secondary school students tied to higher edu3 cation curricula; 

4 ‘‘(C) nurse mentor programs that provide 

5 experience for secondary school students in clin6 ical settings to learn about the nursing profes7 sion; 

8 ‘‘(D) training for middle school and sec9 ondary school guidance counselors; and 

10 ‘‘(E) programs that attract nontraditional 

11 nursing students, including minorities and men; 

12 ‘‘(2) supporting a web-based healthcare work13 force development system that will be a database14 driven website to connect employers, educators, rural 

15 communities, and students with the nursing pipeline 

16 and recruitment programs described in this section; 

17 and 

18 ‘‘(3) increasing the program capacity of acceler19 ated registered nurse programs that recruit individ20 uals with baccalaureate degrees in other fields into 

21 baccalaureate or graduate degree nursing programs 

22 that serve rural communities, by— 

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

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


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1 ‘‘(C) providing financial incentives, includ2 ing loan forgiveness and tuition assistance for 

3 nurses who practice in rural areas. 

4 ‘‘(b) 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 2007 through 2011.’’. 

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

9 Title VIII of the Public Health Service Act (42 

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

11 following: 

12 ‘‘PART J—NURSING AND IMPROVING 

13 HEALTHCARE 

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

15 OUTCOMES PROGRAM. 

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

17 with the Administrator of the Health Resources and Serv18 ices Administration and the Director of the Agency for 

19 Healthcare Research and Quality, shall award grants to 

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

21 enable the entities to carry out demonstration projects 

22 that advance the education, delivery, or measurement of 

23 quality and patient safety in nursing practice. 


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1 ‘‘(b) ELIGIBILITY.—To be eligible to receive a dem2 onstration project grant under this section, an entity 

3 shall— 

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

5 an academic health center, a State or local govern6 ment, or any other public or private nonprofit entity 

7 determined appropriate by the Secretary; 

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

9 accordance with section 802; 

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

11 entities; and 

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

13 assures grant funds received under this section will 

14 be used to support the implementation and evalua15 tion of healthcare quality improvement activities that 

16 include— 

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

18 activities relating to improving patient safety, 

19 timeliness of care, effectiveness of care, equity 

20 and efficiency of care, and patient-centeredness; 

21 or 

22 ‘‘(B) with respect to patients, activities, in23 cluding activities relating to staying healthy, 

24 getting well, living with illness or disability, and 

25 coping with end of life issues. 


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1 ‘‘(c) PRIORITY.—In awarding grants under sub2 section (a), the Secretary shall give priority to entities that 

3 will carry out 1 or more of the following: 

4 ‘‘(1) IMPLEMENTATION.—Implementing initia5 tives in professional nursing education to enhance 

6 patient safety efforts through evidence-based prac7 tice and quality improvement strategies by— 

8 ‘‘(A) developing partnerships between ac9 credited schools of nursing and health care fa10 cilities, as defined in section 801, to educate 

11 registered nurses in clinical leadership, inter12 disciplinary team management, systems admin13 istration, outcomes and risk management, and 

14 education, for implementation in multiple 

15 healthcare settings; and 

16 ‘‘(B) providing scholarships for registered 

17 professional nurses to pursue advanced nursing 

18 education in accordance with subsection (a). 

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

20 safety competencies into nursing education programs 

21 by— 

22 ‘‘(A) disseminating patient safety edu23 cation content to a nurse faculty administrator 

24 to integrate quality competencies into each 

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1 nical standards that are developed or adopted 

2 by voluntary consensus standards bodies under 

3 section 12(d) of the National Technology 

4 Transfer and Advancement Act of 1995 (15 

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

6 ‘‘(B) developing ongoing web-based mod7 ules for continued nurse faculty education to 

8 bring research evidence into practice not later 

9 than 2 years after receiving a grant under this 

10 section; and 

11 ‘‘(3) provide continuing education for practicing 

12 nurses, including— 

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

14 to patient safety, including topics of evidenced15 based practice, professional communication, pa16 tient or family-centered care, systems thinking, 

17 informatics, collaborative practice, medication, 

18 and practice error; and 

19 ‘‘(B) developing systems for the dissemina20 tion of continuing education through facility21 based staff development and orientation. 

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

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

24 data and study the potential benefits of basic and ad25 vanced nursing education levels or certification status in 


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1 the efforts to promote quality improvement strategies and 

2 enhance patient outcomes and cost saving measures, by— 

3 ‘‘(1) compiling and analyzing quality indicator 

4 data from existing databases and other sources to 

5 evaluate relationships between basic and advanced 

6 nursing education levels or certification status on 

7 nursing sensitive indicators and quality outcomes; 

8 ‘‘(2) working in consultation with State depart9 ments of health or other nonprofit patient safety or10 ganizations; or 

11 ‘‘(3) demonstrating the cost savings and sus12 tainability of the demonstration projects. 

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

14 of enactment of the Nursing Education and Quality of 

15 Health Care Act of 2006, the Secretary shall submit a 

16 report to Congress on the results of the program under 

17 this section. 

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

19 are authorized to be appropriated to carry out this section 

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

21 2007 through 2011.’’. 

Æ 


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