I 

108TH CONGRESS 

2D SESSION H. R. 5324 

To amend the Public Health Service Act to authorize capitation grants to 

increase the number of nursing faculty and students, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 8, 2004 

Mrs. LOWEY (for herself and Mrs. CAPPS) introduced the following bill; which 

was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty 

and students, 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 ‘‘Nurse Education, Ex5 pansion, and Development Act of 2004’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds as follows: 

8 (1) While the Nurse Reinvestment Act (Public 

9 Law 107–205) helped to increase applications to 

10 schools of nursing by 60 percent, schools of nursing 
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1 have been unable to accommodate the influx of in2 terested students because they have an insufficient 

3 number of nurse educators. It is estimated that— 

4 (A) in the 2003–2004 school year— 

5 (i) 61.5 percent of schools of nursing 

6 had from 1 to 15 vacant faculty positions; 

7 and 

8 (ii) an additional 30.9 percent of 

9 schools of nursing needed additional fac10 ulty, but lacked the resources needed to 

11 add more positions; and 

12 (B) 18,105 eligible candidates were denied 

13 admission to schools of nursing in 2003, pri14 marily due to an insufficient number of faculty 

15 members. 

16 (2) A growing number of nurses with doctoral 

17 degrees are choosing careers outside of education. 

18 Over the last few years, there has been a 12 percent 

19 increase in doctoral nursing graduates seeking em20 ployment outside the education profession. 

21 (3) The average age of nurse faculty at retire22 ment is 62.5 years. With the average age of 

23 doctorally-prepared faculty currently 53.5 years, a 

24 wave of retirements is expected within the next 10 

25 years. 
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1 (4) Master’s and doctoral programs in nursing 

2 are not producing a large enough pool of potential 

3 nurse educators to meet the projected demand for 

4 nurses over the next 10 years. In the 2003–2004 

5 school year, graduations from master’s programs in 

6 nursing were down 2.5 percent or 251 graduates, 

7 and graduations from doctoral programs decreased 

8 by 9.9 percent or 44 graduates. 

9 (5) According to the February 2004 Monthly 

10 Labor Review of the Bureau of Labor Statistics, 

11 more than 1,000,000 new and replacement nurses 

12 will be needed by 2012. 

13 SEC. 3. CAPITATION GRANTS TO INCREASE THE NUMBER 

14 OF NURSING FACULTY AND STUDENTS. 

15 (a) GRANTS.—Part D of title VIII of the Public 

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

18 ‘‘SEC. 832. CAPITATION GRANTS. 

19 ‘‘(a) IN GENERAL.—For the purpose described in 

20 subsection (b), the Secretary, acting through the Health 

21 Resources and Services Administration, shall award a 

22 grant each fiscal year in an amount determined in accord23 ance with subsection (c) to each eligible school of nursing 

24 that submits an application in accordance with this sec25 tion. 
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1 ‘‘(b) PURPOSE.—A funding agreement for a grant 

2 under this section is that the eligible school of nursing 

3 involved will expend the grant to increase the number of 

4 nursing faculty and students at the school, including by 

5 hiring new faculty, retaining current faculty, purchasing 

6 educational equipment and audiovisual laboratories, en7 hancing clinical laboratories, repairing and expanding in8 frastructure, or recruiting students. 

9 ‘‘(c) GRANT COMPUTATION.— 

10 ‘‘(1) AMOUNT PER STUDENT.—Subject to para11 graph (2), the amount of a grant to an eligible 

12 school of nursing under this section for a fiscal year 

13 shall be the total of the following: 

14 ‘‘(A) $1,800 for each full-time or part-time 

15 student who is enrolled at the school in a grad16 uate program of education in nursing that— 

17 ‘‘(i) leads to a master’s degree, a doc18 toral degree, or an equivalent degree; and 

19 ‘‘(ii) prepares individuals to serve as 

20 faculty through additional course work in 

21 education and ensuring competency in an 

22 advanced practice area. 

23 ‘‘(B) $1,405 for each full-time or part-time 

24 student who— 
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1 ‘‘(i) is enrolled at the school in a pro2 gram of education in nursing leading to 

3 the degree of bachelor of science, bachelor 

4 of nursing, or an equivalent degree; and 

5 ‘‘(ii) has not more than 3 years of 

6 academic credits remaining in the pro7 gram. 

8 ‘‘(C) $966 for each full-time or part-time 

9 student who is enrolled at the school in a pro10 gram of education in nursing leading to an as11 sociate degree in nursing or an equivalent de12 gree. 

13 ‘‘(2) LIMITATION.—In calculating the amount 

14 of a grant to a school under paragraph (1), the Sec15 retary may not make a payment with respect to a 

16 particular student— 

17 ‘‘(A) for more than 2 fiscal years in the 

18 case of a student described in paragraph (1)(A) 

19 who is enrolled in a graduate program of edu20 cation in nursing leading to a master’s degree 

21 or an equivalent degree; 

22 ‘‘(B) for more than 4 fiscal years in the 

23 case of a student described in paragraph (1)(A) 

24 who is enrolled in a graduate program of edu-
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1 cation in nursing leading to a doctoral degree 

2 or an equivalent degree; 

3 ‘‘(C) for more than 3 fiscal years in the 

4 case of a student described in paragraph 

5 (1)(B); or 

6 ‘‘(D) for more than 2 fiscal years in the 

7 case of a student described in paragraph 

8 (1)(C). 

9 ‘‘(d) ELIGIBILITY.—For purposes of this section, the 

10 term ‘eligible school of nursing’ means a school of nursing 

11 that— 

12 ‘‘(1) is accredited by a nursing accrediting 

13 agency recognized by the Secretary of Education; 

14 ‘‘(2) has a passage rate on the National Council 

15 Licensure Examination for Registered Nurses of not 

16 less than 80 percent for each of the 3 school years 

17 preceding submission of the grant application; and 

18 ‘‘(3) has a graduation rate (based on the num19 ber of students in a class who graduate relative to, 

20 for a baccalaureate program, the number of students 

21 who were enrolled in the class at the beginning of 

22 junior year or, for an associate degree program, the 

23 number of students who were enrolled in the class 

24 at the end of the first year) of not less than 80 per-
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1 cent for each of the 3 school years preceding submis2 sion of the grant application. 

3 ‘‘(e) REQUIREMENTS.—The Secretary may award a 

4 grant under this section to an eligible school of nursing 

5 only if the school gives assurances satisfactory to the Sec6 retary that, for each school year for which the grant is 

7 awarded, the school will comply with the following: 

8 ‘‘(1) The school will maintain a passage rate on 

9 the National Council Licensure Examination for 

10 Registered Nurses of not less than 80 percent. 

11 ‘‘(2) The school will maintain a graduation rate 

12 (as described in subsection (d)(3)) of not less than 

13 80 percent. 

14 ‘‘(3)(A) Subject to subparagraphs (B) and (C), 

15 the first-year enrollment of full-time nursing stu16 dents in the school will exceed such enrollment for 

17 the preceding school year by 5 percent or 5 students, 

18 whichever is greater. 

19 ‘‘(B) Subparagraph (A) does not apply to the 

20 first school year for which a school receives a grant 

21 under this section. 

22 ‘‘(C) With respect to any school year, the Sec23 retary may waive application of subparagraph (A) 

24 if— 
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1 ‘‘(i) the physical facilities at the school in2 volved limit the school from enrolling additional 

3 students; or 

4 ‘‘(ii) the school has increased enrollment in 

5 the school (as described in subparagraph (A)) 

6 for each of the 2 preceding school years. 

7 ‘‘(4) Not later than 1 year after receipt of the 

8 grant, the school will formulate and implement a 

9 plan to accomplish at least 2 of the following: 

10 ‘‘(A) Establishing or significantly expand11 ing an accelerated baccalaureate degree nursing 

12 program designed to graduate new nurses in 12 

13 to 18 months. 

14 ‘‘(B) Establishing cooperative 

15 intradisciplinary education among schools of 

16 nursing with a view toward shared use of tech17 nological resources, including information tech18 nology. 

19 ‘‘(C) Establishing cooperative interdiscipli20 nary training between schools of nursing and 

21 schools of allied health, medicine, dentistry, os22 teopathy, optometry, podiatry, pharmacy, public 

23 health, or veterinary medicine, including train24 ing for the use of the interdisciplinary team ap25 proach to the delivery of health services. 
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1 ‘‘(D) Integrating core competencies on evi2 dence-based practice, quality improvements, and 

3 patient-centered care. 

4 ‘‘(E) Increasing admissions, enrollment, 

5 and retention of qualified individuals who are 

6 financially disadvantaged. 

7 ‘‘(F) Increasing enrollment of minority and 

8 diverse student populations. 

9 ‘‘(G) Increasing enrollment of new grad10 uate baccalaureate nursing students in graduate 

11 programs that educate nurse faculty members. 

12 ‘‘(H) Developing post-baccalaureate resi13 dency programs to prepare nurses for practice 

14 in specialty areas where nursing shortages are 

15 most severe. 

16 ‘‘(I) Increasing integration of geriatric con17 tent into the core curriculum. 

18 ‘‘(J) Partnering with economically dis19 advantaged communities to provide nursing 

20 education. 

21 ‘‘(K) Expanding the ability of nurse man22 aged health centers to provide clinical education 

23 training sites to nursing students. 

24 ‘‘(5) The school will submit an annual report to 

25 the Secretary that includes updated information on 
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1 the school with respect to student enrollment, stu2 dent retention, graduation rates, passage rates on 

3 the National Council Licensure Examination for 

4 Registered Nurses, the number of graduates em5 ployed as nursing faculty or nursing care providers 

6 within 12 months of graduation, and the number of 

7 students who are accepted into graduate programs 

8 for further nursing education. 

9 ‘‘(6) The school will allow the Secretary to 

10 make on-site inspections, and will comply with the 

11 Secretary’s requests for information, to determine 

12 the extent to which the school is complying with the 

13 requirements of this section. 

14 ‘‘(g) REPORTS TO CONGRESS.—The Secretary shall 

15 evaluate the results of grants under this section and sub16 mit to the Congress— 

17 ‘‘(1) not later than 18 months after the date of 

18 the enactment of this section, an interim report on 

19 such results; and 

20 ‘‘(2) not later than the end of fiscal year 2007, 

21 a final report on such results. 

22 ‘‘(h) APPLICATION.—To seek a grant under this sec23 tion, a school nursing shall submit an application to the 

24 Secretary at such time, in such manner, and containing 
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1 such information and assurances as the Secretary may re2 quire. 

3 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 

4 ‘‘(1) IN GENERAL.—For the costs of carrying 

5 out this section (except the costs described in para6 graph (2)), there are authorized to be appropriated 

7 $75,000,000 for fiscal year 2005, $85,000,000 for 

8 fiscal year 2006, and $95,000,000 for fiscal year 

9 2007. 

10 ‘‘(2) ADMINISTRATIVE COSTS.—For the costs of 

11 administering this section, including the costs of 

12 evaluating the results of grants and submitting re13 ports to the Congress, there are authorized to be ap14 propriated such sums as may be necessary for each 

15 of fiscal years 2005, 2006, and 2007.’’. 

16 (b) GAO STUDY.— 

17 (1) IN GENERAL.—Not later than 1 year after 

18 the date of the enactment of this Act, the Comp19 troller General of the United States shall conduct a 

20 study and submit a report to the Congress on ways 

21 to increase participation in the nurse faculty profes22 sion. 

23 (2) CONTENTS OF REPORT.—The report re24 quired by paragraph (1) shall include the following: 
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1 (A) A discussion of the master’s degree 

2 and doctoral degree programs that are success3 ful in placing graduates as faculty in schools of 

4 nursing. 

5 (B) An examination of compensation dis6 parities throughout the nursing profession and 

7 compensation disparities between higher edu8 cation instructional faculty generally and higher 

9 education instructional nursing faculty. 

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