I 

111TH CONGRESS 

1ST SESSION H. R. 2731 

To fund comprehensive programs to ensure an adequate supply of nurses. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 4, 2009 

Mrs. MCCARTHY of New York introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to 

the Committee on Education and Labor, for a period to be subsequently 

determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To fund comprehensive programs to ensure an adequate 

supply of nurses. 

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 Training and 

5 Retention Act of 2009’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 


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1 (1) America’s healthcare system depends on an 

2 adequate supply of trained nurses to deliver quality 

3 patient care. 

4 (2) Over the next 15 years, this shortage is ex5 pected to grow significantly. The Health Resources 

6 and Services Administration has projected that by 

7 2020, there will be a shortage of nurses in every 

8 State and that overall only 64 percent of the de9 mand for nurses will be satisfied, with a shortage of 

10 1,016,900 nurses nationally. 

11 (3) To avert such a shortage, today’s network 

12 of healthcare workers should have access to edu13 cation and support from their employers to partici14 pate in educational and training opportunities. 

15 (4) With the appropriate education and sup16 port, incumbent healthcare workers and incumbent 

17 bedside nurses are untapped sources which can meet 

18 these needs and address the nursing shortage and 

19 provide quality care as the American population 

20 ages. 

21 SEC. 3. ESTABLISHMENT OF GRANT PROGRAM. 

22 (a) PURPOSES.—It is the purpose of this section to 

23 authorize grants to— 

24 (1) address the projected shortage of nurses by 

25 funding comprehensive programs to create a career 


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1 ladder to nursing (including Certified Nurse Assist2 ants, Licensed Practical Nurses, Licensed Vocational 

3 Nurses, and Registered Nurses) for incumbent ancil4 lary healthcare workers; 

5 (2) increase the capacity for educating nurses 

6 by increasing both nurse faculty and clinical oppor7 tunities through collaborative programs between 

8 staff nurse organizations, healthcare providers, and 

9 accredited schools of nursing; and 

10 (3) provide training programs through edu11 cation and training organizations jointly adminis12 tered by healthcare providers and healthcare labor 

13 organizations or other organizations representing 

14 staff nurses and frontline healthcare workers, work15 ing in collaboration with accredited schools of nurs16 ing and academic institutions. 

17 (b) GRANTS.—Not later than 6 months after the date 

18 of enactment of this Act, the Secretary of Labor (referred 

19 to in this section as the ‘‘Secretary’’) shall establish a 

20 partnership grant program to award grants to eligible en21 tities to carry out comprehensive programs to provide edu22 cation to nurses and create a pipeline to nursing for in23 cumbent ancillary healthcare workers who wish to advance 

24 their careers, and to otherwise carry out the purposes of 

25 this section. 


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1 (c) ELIGIBLE ENTITIES.—To be eligible to receive a 

2 grant under this section an entity shall— 

3 (1) be— 

4 (A) a healthcare entity that is jointly ad5 ministered by a healthcare employer and a labor 

6 union representing the healthcare employees of 

7 the employer and that carries out activities 

8 using labor management training funds as pro9 vided for under section 302 of the Labor-Man10 agement Relations Act, 1947 (18 U.S.C. 

11 186(c)(6)); 

12 (B) an entity that operates a training pro13 gram that is jointly administered by— 

14 (i) one or more healthcare providers 

15 or facilities, or a trade association of 

16 healthcare providers; and 

17 (ii) one or more organizations which 

18 represent the interests of direct care 

19 healthcare workers or staff nurses and in 

20 which the direct care healthcare workers or 

21 staff nurses have direct input as to the 

22 leadership of the organization; or 

23 (C) a State training partnership program 

24 that consists of non-profit organizations that 

25 include equal participation from industry, inVerDate Nov 24 2008 01:04 Jun 06, 2009 Jkt 079200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2731.IH H2731

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1 cluding public or private employers, and labor 

2 organizations including joint labor-management 

3 training programs, and which may include rep4 resentatives from local governments, worker in5 vestment agency one-stop career centers, com6 munity based organizations, community col7 leges, and accredited schools of nursing; and 

8 (2) submit to the Secretary an application at 

9 such time, in such manner, and containing such in10 formation as the Secretary may require. 

11 (d) ADDITIONAL REQUIREMENTS FOR HEALTHCARE

12 EMPLOYER DESCRIBED IN SUBSECTION (c).—To be eligi13 ble for a grant under this section, a healthcare employer 

14 described in subsection (c) shall demonstrate— 

15 (1) an established program within their facility 

16 to encourage the retention of existing nurses; 

17 (2) it provides wages and benefits to its nurses 

18 that are competitive for its market or that have been 

19 collectively bargained with a labor organization; and 

20 (3) support for programs funded under this sec21 tion through 1 or more of the following: 

22 (A) The provision of paid leave time and 

23 continued health coverage to incumbent 

24 healthcare workers to allow their participation 

25 in nursing career ladder programs, including 


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1 Certified Nurse Assistants, Licensed Practical 

2 Nurses, Licensed Vocational Nurses, and Reg3 istered Nurses. 

4 (B) Contributions to a joint labor-manage5 ment training fund which administers the pro6 gram involved. 

7 (C) The provision of paid release time, in8 centive compensation, or continued health cov9 erage to staff nurses who desire to work full- or 

10 part-time in a faculty position. 

11 (D) The provision of paid release time for 

12 staff nurses to enable them to obtain a Bach13 elor of Science in Nursing degree, other ad14 vanced nursing degrees, specialty training, or 

15 certification program. 

16 (E) The payment of tuition assistance 

17 which is managed by a joint labor-management 

18 training fund or other jointly administered pro19 gram. 

20 (e) OTHER REQUIREMENTS.— 

21 (1) MATCHING REQUIREMENT.— 

22 (A) IN GENERAL.—The Secretary may not 

23 make a grant under this section unless the ap24 plicant involved agrees, with respect to the costs 

25 to be incurred by the applicant in carrying out 


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1 the program under the grant, to make available 

2 non-Federal contributions (in cash or in kind 

3 under subparagraph (B)) toward such costs in 

4 an amount equal to not less than $1 for each 

5 $1 of Federal funds provided in the grant. Such 

6 contributions may be made directly or through 

7 donations from public or private entities, or 

8 may be provided through the cash equivalent of 

9 paid release time provided to incumbent worker 

10 students. 

11 (B) DETERMINATION OF AMOUNT OF NON12 FEDERAL CONTRIBUTION.—Non-Federal con13 tributions required in subparagraph (A) may be 

14 in cash or in kind (including paid release time), 

15 fairly evaluated, including equipment or services 

16 (and excluding indirect or overhead costs). 

17 Amounts provided by the Federal Government, 

18 or services assisted or subsidized to any signifi19 cant extent by the Federal Government, may 

20 not be included in determining the amount of 

21 such non-Federal contributions. 

22 (2) REQUIRED COLLABORATION.—Entities car23 rying out or overseeing programs carried out with 

24 assistance provided under this section shall dem25 onstrate collaboration with accredited schools of 


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1 nursing which may include community colleges and 

2 other academic institutions providing Associate, 

3 Bachelor’s, or advanced nursing degree programs or 

4 specialty training or certification programs. 

5 (f) ACTIVITIES.—Amounts awarded to an entity 

6 under a grant under this section shall be used for the fol7 lowing: 

8 (1) To carry out programs that provide edu9 cation and training to establish nursing career lad10 ders to educate incumbent healthcare workers to be11 come nurses (including Certified Nurse Assistants, 

12 Licensed Practical Nurses, Licensed Vocational 

13 Nurses, and Registered Nurses). Such programs 

14 shall include one or more of the following: 

15 (A) Preparing incumbent workers to return 

16 to the classroom through English as a second 

17 language education, GED education, pre-college 

18 counseling, college preparation classes, and sup19 port with entry level college classes that are a 

20 prerequisite to nursing. 

21 (B) Providing tuition assistance with pref22 erence for dedicated cohort classes in commu23 nity colleges, universities, accredited schools of 

24 nursing with supportive services including tu25 toring and counseling. 


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1 (C) Providing assistance in preparing for 

2 and meeting all nursing licensure tests and re3 quirements. 

4 (D) Carrying out orientation and 

5 mentorship programs that assist newly grad6 uated nurses in adjusting to working at the 

7 bedside to ensure their retention post gradua8 tion, and ongoing programs to support nurse 

9 retention. 

10 (E) Providing stipends for release time and 

11 continued healthcare coverage to enable incum12 bent healthcare workers to participate in these 

13 programs. 

14 (2) To carry out programs that assist nurses in 

15 obtaining advanced degrees and completing specialty 

16 training or certification programs and to establish 

17 incentives for nurses to assume nurse faculty posi18 tions on a part-time or full-time basis. Such pro19 grams shall include one or more of the following: 

20 (A) Increasing the pool of nurses with ad21 vanced degrees who are interested in teaching 

22 by funding programs that enable incumbent 

23 nurses to return to school. 

24 (B) Establishing incentives for advanced 

25 degree bedside nurses who wish to teach in 


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1 nursing programs so they can obtain a leave 

2 from their bedside position to assume a full- or 

3 part-time position as adjunct or full-time fac4 ulty without the loss of salary or benefits. 

5 (C) Collaboration with accredited schools 

6 of nursing which may include community col7 leges and other academic institutions providing 

8 Associate, Bachelor’s, or advanced nursing de9 gree programs, or specialty training or certifi10 cation programs, for nurses to carry out innova11 tive nursing programs which meet the needs of 

12 bedside nursing and healthcare providers. 

13 (g) PREFERENCE.—In awarding grants under this 

14 section the Secretary shall give preference to programs 

15 that— 

16 (1) provide for improving nurse retention; 

17 (2) provide for improving the diversity of the 

18 new nurse graduates to reflect changes in the demo19 graphics of the patient population; 

20 (3) provide for improving the quality of nursing 

21 education to improve patient care and safety; 

22 (4) have demonstrated success in upgrading in23 cumbent healthcare workers to become nurses or 

24 which have established effective programs or pilots 

25 to increase nurse faculty; or 


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1 (5) are modeled after or affiliated with such 

2 programs described in paragraph (4). 

3 (h) EVALUATION.— 

4 (1) PROGRAM EVALUATIONS.—An entity that 

5 receives a grant under this section shall annually 

6 evaluate, and submit to the Secretary a report on, 

7 the activities carried out under the grant and the 

8 outcomes of such activities. Such outcomes may in9 clude— 

10 (A) an increased number of incumbent 

11 workers entering an accredited school of nurs12 ing and in the pipeline for nursing programs; 

13 (B) an increasing number of graduating 

14 nurses and improved nurse graduation and li15 censure rates; 

16 (C) improved nurse retention; 

17 (D) an increase in the number of staff 

18 nurses at the healthcare facility involved; 

19 (E) an increase in the number of nurses 

20 with advanced degrees in nursing; 

21 (F) an increase in the number of nurse 

22 faculty; 

23 (G) improved measures of patient quality 

24 (which may include staffing ratios of nurses, 


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1 patient satisfaction rates, patient safety meas2 ures); and 

3 (H) an increase in the diversity of new 

4 nurse graduates relative to the patient popu5 lation. 

6 (2) GENERAL REPORT.—Not later than 2 years 

7 after the date of enactment of this Act, and annually 

8 thereafter, the Secretary of Labor shall, using data 

9 and information from the reports received under 

10 paragraph (1), submit to Congress a report con11 cerning the overall effectiveness of the grant pro12 gram carried out under this section. 

13 (i) AUTHORIZATION OF APPROPRIATIONS.—There 

14 are authorized to be appropriated to carry out this section, 

15 such sums as may be necessary. 

Æ 


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