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 re-
ferred 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 provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To fund comprehensive programs to ensure an adequate 
supply of nurses. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Nurse Training and 
Retention Act of 2009’’. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
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(1) America’s healthcare system depends on an 
adequate supply of trained nurses to deliver quality 
patient care. 
(2) Over the next 15 years, this shortage is ex-
pected to grow significantly. The Health Resources 
and Services Administration has projected that by 
2020, there will be a shortage of nurses in every 
State and that overall only 64 percent of the de-
mand for nurses will be satisfied, with a shortage of 
1,016,900 nurses nationally. 
(3) To avert such a shortage, today’s network 
of healthcare workers should have access to edu-
cation and support from their employers to partici-
pate in educational and training opportunities. 
(4) With the appropriate education and sup-
port, incumbent healthcare workers and incumbent 
bedside nurses are untapped sources which can meet 
these needs and address the nursing shortage and 
provide quality care as the American population 
ages. 
SEC. 3. ESTABLISHMENT OF GRANT PROGRAM. 
(a) PURPOSES.—It is the purpose of this section to 
authorize grants to— 
(1) address the projected shortage of nurses by 
funding comprehensive programs to create a career 
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ladder to nursing (including Certified Nurse Assist-
ants, Licensed Practical Nurses, Licensed Vocational 
Nurses, and Registered Nurses) for incumbent ancil-
lary healthcare workers; 
(2) increase the capacity for educating nurses 
by increasing both nurse faculty and clinical oppor-
tunities through collaborative programs between 
staff nurse organizations, healthcare providers, and 
accredited schools of nursing; and 
(3) provide training programs through edu-
cation and training organizations jointly adminis-
tered by healthcare providers and healthcare labor 
organizations or other organizations representing 
staff nurses and frontline healthcare workers, work-
ing in collaboration with accredited schools of nurs-
ing and academic institutions. 
(b) GRANTS.—Not later than 6 months after the date 
of enactment of this Act, the Secretary of Labor (referred 
to in this section as the ‘‘Secretary’’) shall establish a 
partnership grant program to award grants to eligible en-
tities to carry out comprehensive programs to provide edu-
cation to nurses and create a pipeline to nursing for in-
cumbent ancillary healthcare workers who wish to advance 
their careers, and to otherwise carry out the purposes of 
this section. 
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(c) ELIGIBLE ENTITIES.—To be eligible to receive a 
grant under this section an entity shall— 
(1) be— 
(A) a healthcare entity that is jointly ad-
ministered by a healthcare employer and a labor 
union representing the healthcare employees of 
the employer and that carries out activities 
using labor management training funds as pro-
vided for under section 302 of the Labor-Man-
agement Relations Act, 1947 (18 U.S.C. 
186(c)(6)); 
(B) an entity that operates a training pro-
gram that is jointly administered by— 
(i) one or more healthcare providers 
or facilities, or a trade association of 
healthcare providers; and 
(ii) one or more organizations which 
represent the interests of direct care 
healthcare workers or staff nurses and in 
which the direct care healthcare workers or 
staff nurses have direct input as to the 
leadership of the organization; or 
(C) a State training partnership program 
that consists of non-profit organizations that 
include equal participation from industry, in-
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cluding public or private employers, and labor 
organizations including joint labor-management 
training programs, and which may include rep-
resentatives from local governments, worker in-
vestment agency one-stop career centers, com-
munity based organizations, community col-
leges, and accredited schools of nursing; and 
(2) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require. 
(d) ADDITIONAL REQUIREMENTS FOR HEALTHCARE 
EMPLOYER DESCRIBED IN SUBSECTION (c).—To be eligi-
ble for a grant under this section, a healthcare employer 
described in subsection (c) shall demonstrate— 
(1) an established program within their facility 
to encourage the retention of existing nurses; 
(2) it provides wages and benefits to its nurses 
that are competitive for its market or that have been 
collectively bargained with a labor organization; and 
(3) support for programs funded under this sec-
tion through 1 or more of the following: 
(A) The provision of paid leave time and 
continued 
health 
coverage 
to 
incumbent 
healthcare workers to allow their participation 
in nursing career ladder programs, including 
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Certified Nurse Assistants, Licensed Practical 
Nurses, Licensed Vocational Nurses, and Reg-
istered Nurses. 
(B) Contributions to a joint labor-manage-
ment training fund which administers the pro-
gram involved. 
(C) The provision of paid release time, in-
centive compensation, or continued health cov-
erage to staff nurses who desire to work full- or 
part-time in a faculty position. 
(D) The provision of paid release time for 
staff nurses to enable them to obtain a Bach-
elor of Science in Nursing degree, other ad-
vanced nursing degrees, specialty training, or 
certification program. 
(E) The payment of tuition assistance 
which is managed by a joint labor-management 
training fund or other jointly administered pro-
gram. 
(e) OTHER REQUIREMENTS.— 
(1) MATCHING REQUIREMENT.— 
(A) IN GENERAL.—The Secretary may not 
make a grant under this section unless the ap-
plicant involved agrees, with respect to the costs 
to be incurred by the applicant in carrying out 
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the program under the grant, to make available 
non-Federal contributions (in cash or in kind 
under subparagraph (B)) toward such costs in 
an amount equal to not less than $1 for each 
$1 of Federal funds provided in the grant. Such 
contributions may be made directly or through 
donations from public or private entities, or 
may be provided through the cash equivalent of 
paid release time provided to incumbent worker 
students. 
(B) DETERMINATION OF AMOUNT OF NON- 
FEDERAL
CONTRIBUTION.—Non-Federal con-
tributions required in subparagraph (A) may be 
in cash or in kind (including paid release time), 
fairly evaluated, including equipment or services 
(and excluding indirect or overhead costs). 
Amounts provided by the Federal Government, 
or services assisted or subsidized to any signifi-
cant extent by the Federal Government, may 
not be included in determining the amount of 
such non-Federal contributions. 
(2) REQUIRED COLLABORATION.—Entities car-
rying out or overseeing programs carried out with 
assistance provided under this section shall dem-
onstrate collaboration with accredited schools of 
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nursing which may include community colleges and 
other academic institutions providing Associate, 
Bachelor’s, or advanced nursing degree programs or 
specialty training or certification programs. 
(f) ACTIVITIES.—Amounts awarded to an entity 
under a grant under this section shall be used for the fol-
lowing: 
(1) To carry out programs that provide edu-
cation and training to establish nursing career lad-
ders to educate incumbent healthcare workers to be-
come nurses (including Certified Nurse Assistants, 
Licensed Practical Nurses, Licensed Vocational 
Nurses, and Registered Nurses). Such programs 
shall include one or more of the following: 
(A) Preparing incumbent workers to return 
to the classroom through English as a second 
language education, GED education, pre-college 
counseling, college preparation classes, and sup-
port with entry level college classes that are a 
prerequisite to nursing. 
(B) Providing tuition assistance with pref-
erence for dedicated cohort classes in commu-
nity colleges, universities, accredited schools of 
nursing with supportive services including tu-
toring and counseling. 
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