(B) a description of the types of programs
and activities for which the grant is sought.
(2) NOTICE OF APPROVAL OR DISAPPROVAL.—
Each nursing facility submitting an application
under paragraph (1) shall, not later than 60 days
after the date of its submission, be notified in writ-
ing as to whether such application is approved or
disapproved.
(c) DURATION.—A grant under this section may ex-
tend over a period of not more than three years.
(d) ANNUAL APPROVAL.—The provision of payments
under a grant under this section shall be subject to annual
approval by the Secretary and subject to the availability
of appropriations for each fiscal year to make the pay-
ments.
(e) USE OF GRANT FUNDS.—
(1) AUTHORIZED USES.—A grant made under
this section shall be used by the nursing facility,
with respect to individuals who furnish direct resi-
dent care services in nursing facilities, including reg-
istered professional nurses, licensed practical nurses,
and certified nurse aides, to do any or all of the fol-
lowing:
(A) Increase the salary of such individuals.
(B) Reimburse all or part of the out-
standing balance of any education loan under-
taken by the individual.
(C) Reduce payments due under other obli-
gations imposed under an agreement of a pro-
gram under the Public Health Service Act (42
U.S.C. 201 et seq.).
(D) With respect to certified nurse aides,
subsidize the costs of (i) the employee share of
employer-based health care coverage, and (ii)
child care expenses of the aides.
(E) Subsidize the costs of transportation
to and from the nursing facility of such individ-
uals.
(2) PROHIBITED USES.—A grant may not be
used by a nursing facility to offset salary and bene-
fits that would be otherwise payable by the facility
to such individuals in the absence of the grant.
(f) REPORTS.—A nursing facility awarded a grant
under this section shall submit to the Secretary such re-
ports, and within such time frames, as the Secretary may
require. The report shall include such information and
data as the Secretary requires to determine compliance of
the nursing facility with the provisions of this section.
(g) REGULATIONS.—Any regulations to carry out this
section shall be prescribed not later than 60 days after
the date of enactment of this section.
(h) AUTHORIZATION OF APPROPRIATIONS.—For pur-
poses of carrying out this section, there are authorized to
be appropriated to the Secretary $25,000,000 for each of
fiscal years 2001, 2002, and 2003. 60 percent of such ap-
propriation shall be payable from the Federal Hospital In-
surance Trust Fund, and 40 percent of such appropriation
shall be payable from the Federal Supplementary Medical
Insurance Trust Fund under title XVIII of the Social Se-
curity Act (42 U.S.C. 1395i, 1395t).
(i) DEFINITIONS.—In this section:
(1) The term ‘‘Secretary’’ means the Secretary
of Health and Human Services.
(2) The term ‘‘nursing facility’’ has the mean-
ing given that term in section 1919(a) of the Social
Security Act (42 U.S.C. 1396r(a)), and includes a
skilled nursing facility (as defined in section 1819(a)
of such Act (42 U.S.C. 1395i–3(a)).
SEC. 204. IMPROVEMENT IN WORKER SAFETY.
(a) GRANT PROGRAM.—
(1) IN GENERAL.—The Secretary shall, in ac-
cordance with the provisions of this section, award
grants to nursing facilities to establish model work-
place safety programs. Such programs shall be de-
signed to result in a significant reduction in the inci-
dence of accidents and injuries at the nursing facil-
ity to employees of the nursing facility.
(2) PRIORITY OF GRANT AWARDS.—In award-
ing grants under this section, the Secretary shall
give priority to nursing facilities with approved ap-
plications filed in partnership with labor representa-
tives.
(3) DEADLINE FOR INITIAL GRANT AWARDS.—
The Secretary shall award grants under this section
by not later than 6 months after the date of the en-
actment of this Act.
(4) COORDINATION WITH THE SECRETARY OF
LABOR.—The Secretary shall coordinate the imple-
mentation of the grant program established under
this section with the Secretary of Labor.
(b) APPLICATIONS.—
(1) APPLICATIONS
REQUIRED.—Each nursing
facility that wishes to receive a grant under this sec-
tion shall submit an application at such time, in
such form, and complete with such information as
the Secretary shall by regulation require, except that
any such application shall include at least—
(A) a statement of the objectives for which
the grant is sought;
(B) a description of the types of programs
and activities for which the grant is sought;
(C) a plan for the timely implementation of
the program and evaluation of the program in
the facility; and
(D) consultation with a State long-term
care Ombudsman or a community-based citizen
advocacy group.
(2) NOTICE OF APPROVAL OR DISAPPROVAL.—
Each nursing facility submitting an application
under paragraph (1) shall, not later than 60 days
after the date of its submission, be notified in writ-
ing as to whether such application is approved or
disapproved.
(3) REQUIREMENT OF PRIOR APPROVAL FROM
COLLECTIVE BARGAINING AGENCY.—In the case of a
nursing facility applying for a grant under this sec-
tion that has a collective bargaining agent, the appli-
cation filed by the facility shall include written ap-
proval from that agent for the facility’s proposed use
of the grant award.
(c) DURATION.—A grant under this section may ex-
tend over a period of not more than three years.
(d) ANNUAL APPROVAL.—The provision of payments
under a grant under this section shall be subject to annual
approval by the Secretary and subject to the availability
of appropriations for each fiscal year to make the pay-
ments.
(e) USE OF GRANT FUNDS.—A grant made under
this section may be used only to establish and carry out
the model workplace safety program referred to in sub-
section (a)(1).
(f) REPORTS.—A nursing facility awarded a grant
under this section shall submit to the Secretary such re-
ports, and within such time frames, as the Secretary may
require.
(g) REGULATIONS.—Any regulations to carry out this
section shall be prescribed not later than 60 days after
the date of enactment of this section.
(h) AUTHORIZATION OF APPROPRIATIONS.—For pur-
poses of carrying out this section, there are authorized to
be appropriated to the Secretary $25,000,000 for each of
fiscal years 2001, 2002, and 2003. 60 percent of such ap-
propriation shall be payable from the Federal Hospital In-
surance Trust Fund, and 40 percent of such appropriation
shall be payable from the Federal Supplementary Medical
Insurance Trust Fund under title XVIII of the Social Se-
curity Act (42 U.S.C. 1395i, 1395t).
(i) DEFINITIONS.—In this section:
(1) The term ‘‘Secretary’’ means the Secretary
of Health and Human Services.
(2) The term ‘‘nursing facility’’ has the mean-
ing given that term in section 1919(a) of the Social
Security Act (42 U.S.C. 1396r(a)), and includes a
skilled nursing facility (as defined in section 1819(a)
of such Act (42 U.S.C. 1395i–3(a)).
(3) The term ‘‘model safety workplace pro-
gram’’ means a program certified by an appropriate
worker safety training expert (as determined by the
Secretary) to reduce the incidence of accidents and
injuries at nursing facilities, including such acci-
dents and injuries associated with the lifting and
transportation of residents of the facility, stress re-
duction activities, and compliance with workplace
safety standards (such as standards to reduce acci-
dental needle stick injuries).
SEC. 205. DEMONSTRATION PROGRAM TO IMPLEMENT
QUALITY IMPROVEMENT MODELS IN NURS-
ING FACILITY SETTINGS.
(a) QUALITY IMPROVEMENT MODELS.—
(1) IN GENERAL.—The Secretary shall provide
for a demonstration project under this section under
which grants are made to 4 States to implement in-
novative quality improvement models (described in
paragraph (2) to improve the quality of care fur-
nished to residents of nursing facilities operating in
the State.
(2) MODELS DESCRIBED.—A model referred to
in paragraph (1) is a model developed by the Agency
for Healthcare Research and Quality, the American
Medical Directors Association, and the Nutrician In-
stitute to reduce the incidence and prevalence of in-
fections, bed sores, incontinence, and lack of mobil-
ity among such residents.
(b) APPLICATION.—
(1) APPLICATIONS
REQUIRED.—Each State
that wishes to receive a grant under this section
shall submit an application at such time, in such
form, and complete with such information as the
Secretary shall by regulation require, except that
any such application shall include at least—
(A) a statement of the objectives for which
the grant is sought;
(B) a description of the types of programs
and activities for which the grant is sought; and
(C) consultation with a State long-term
care Ombudsman or a community-based citizen
advocacy group.
(2) NOTICE OF APPROVAL OR DISAPPROVAL.—
Each State submitting an application under para-
graph (1) shall, not later than 60 days after the
date of its submission, be notified in writing as to
whether such application is approved or disapproved.
(c) DURATION.—A grant under this section may ex-
tend over a period of not more than three years.
(d) ANNUAL APPROVAL.—The provision of payments
under a grant under this section shall be subject to annual
approval by the Secretary and subject to the availability
of appropriations for each fiscal year to make the pay-
ments.
(e) USE OF GRANT FUNDS.—A grant made under
this section may be used only to carry out to innovative
quality improvement models referred to in subsection (a).
(f) REPORTS.—
(1) IN GENERAL.—A State awarded a grant
under this section shall submit to the Secretary such
reports, and within such time frames, as the Sec-
retary may require.
(2) REVIEW BY GAO.—The Comptroller General
of the United States shall submit to Congress a re-
port on the results of the demonstration project
under this section, including in such report an anal-
ysis of the models developed by each State and the
effectiveness of each such model in reducing inconti-
nence and pressure sores among residents of nursing
facilities in each such State.
(g) REGULATIONS.—Any regulations to carry out this
section shall be prescribed not later than 60 days after
the date of enactment of this section.
(h) AUTHORIZATION OF APPROPRIATIONS.—For pur-
poses of carrying out this section, there are authorized to
be appropriated to the Secretary $25,000,000 for each of
fiscal years 2001, 2002, and 2003. 60 percent of such ap-
propriation shall be payable from the Federal Hospital In-
surance Trust Fund, and 40 percent of such appropriation
shall be payable from the Federal Supplementary Medical
Insurance Trust Fund under title XVIII of the Social Se-
curity Act (42 U.S.C. 1395i, 1395t).
(i) DEFINITIONS.—In this section:
(1) The term ‘‘Secretary’’ means the Secretary
of Health and Human Services.
(2) The term ‘‘nursing facility’’ has the mean-
ing given that term in section 1919(a) of the Social
Security Act (42 U.S.C. 1396r(a)), and includes a
skilled nursing facility (as defined in section 1819(a)
of such Act (42 U.S.C. 1395i–3(a)).
Æ