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 capita-
tion grants to increase the number of nursing faculty 
and students, and for other purposes. 
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 Education, Ex-
pansion, and Development Act of 2004’’. 
SEC. 2. FINDINGS. 
The Congress finds as follows: 
(1) While the Nurse Reinvestment Act (Public 
Law 107–205) helped to increase applications to 
schools of nursing by 60 percent, schools of nursing
have been unable to accommodate the influx of in-
terested students because they have an insufficient 
number of nurse educators. It is estimated that— 
(A) in the 2003–2004 school year— 
(i) 61.5 percent of schools of nursing 
had from 1 to 15 vacant faculty positions; 
and 
(ii) an additional 30.9 percent of 
schools of nursing needed additional fac-
ulty, but lacked the resources needed to 
add more positions; and 
(B) 18,105 eligible candidates were denied 
admission to schools of nursing in 2003, pri-
marily due to an insufficient number of faculty 
members. 
(2) A growing number of nurses with doctoral 
degrees are choosing careers outside of education. 
Over the last few years, there has been a 12 percent 
increase in doctoral nursing graduates seeking em-
ployment outside the education profession. 
(3) The average age of nurse faculty at retire-
ment is 62.5 years. With the average age of 
doctorally-prepared faculty currently 53.5 years, a 
wave of retirements is expected within the next 10 
years.
(4) Master’s and doctoral programs in nursing 
are not producing a large enough pool of potential 
nurse educators to meet the projected demand for 
nurses over the next 10 years. In the 2003–2004 
school year, graduations from master’s programs in 
nursing were down 2.5 percent or 251 graduates, 
and graduations from doctoral programs decreased 
by 9.9 percent or 44 graduates. 
(5) According to the February 2004 Monthly 
Labor Review of the Bureau of Labor Statistics, 
more than 1,000,000 new and replacement nurses 
will be needed by 2012. 
SEC. 3. CAPITATION GRANTS TO INCREASE THE NUMBER 
OF NURSING FACULTY AND STUDENTS. 
(a) GRANTS.—Part D of title VIII of the Public 
Health Service Act (42 U.S.C. 296p) is amended by add-
ing at the end the following: 
‘‘SEC. 832. CAPITATION GRANTS. 
‘‘(a) IN GENERAL.—For the purpose described in 
subsection (b), the Secretary, acting through the Health 
Resources and Services Administration, shall award a 
grant each fiscal year in an amount determined in accord-
ance with subsection (c) to each eligible school of nursing 
that submits an application in accordance with this sec-
tion.
‘‘(b) PURPOSE.—A funding agreement for a grant 
under this section is that the eligible school of nursing 
involved will expend the grant to increase the number of 
nursing faculty and students at the school, including by 
hiring new faculty, retaining current faculty, purchasing 
educational equipment and audiovisual laboratories, en-
hancing clinical laboratories, repairing and expanding in-
frastructure, or recruiting students. 
‘‘(c) GRANT COMPUTATION.— 
‘‘(1) AMOUNT PER STUDENT.—Subject to para-
graph (2), the amount of a grant to an eligible 
school of nursing under this section for a fiscal year 
shall be the total of the following: 
‘‘(A) $1,800 for each full-time or part-time 
student who is enrolled at the school in a grad-
uate program of education in nursing that— 
‘‘(i) leads to a master’s degree, a doc-
toral degree, or an equivalent degree; and 
‘‘(ii) prepares individuals to serve as 
faculty through additional course work in 
education and ensuring competency in an 
advanced practice area. 
‘‘(B) $1,405 for each full-time or part-time 
student who—
‘‘(i) is enrolled at the school in a pro-
gram of education in nursing leading to 
the degree of bachelor of science, bachelor 
of nursing, or an equivalent degree; and 
‘‘(ii) has not more than 3 years of 
academic credits remaining in the pro-
gram. 
‘‘(C) $966 for each full-time or part-time 
student who is enrolled at the school in a pro-
gram of education in nursing leading to an as-
sociate degree in nursing or an equivalent de-
gree. 
‘‘(2) LIMITATION.—In calculating the amount 
of a grant to a school under paragraph (1), the Sec-
retary may not make a payment with respect to a 
particular student— 
‘‘(A) for more than 2 fiscal years in the 
case of a student described in paragraph (1)(A) 
who is enrolled in a graduate program of edu-
cation in nursing leading to a master’s degree 
or an equivalent degree; 
‘‘(B) for more than 4 fiscal years in the 
case of a student described in paragraph (1)(A) 
who is enrolled in a graduate program of edu-
cation in nursing leading to a doctoral degree 
or an equivalent degree; 
‘‘(C) for more than 3 fiscal years in the 
case of a student described in paragraph 
(1)(B); or 
‘‘(D) for more than 2 fiscal years in the 
case of a student described in paragraph 
(1)(C). 
‘‘(d) ELIGIBILITY.—For purposes of this section, the 
term ‘eligible school of nursing’ means a school of nursing 
that— 
‘‘(1) is accredited by a nursing accrediting 
agency recognized by the Secretary of Education; 
‘‘(2) has a passage rate on the National Council 
Licensure Examination for Registered Nurses of not 
less than 80 percent for each of the 3 school years 
preceding submission of the grant application; and 
‘‘(3) has a graduation rate (based on the num-
ber of students in a class who graduate relative to, 
for a baccalaureate program, the number of students 
who were enrolled in the class at the beginning of 
junior year or, for an associate degree program, the 
number of students who were enrolled in the class 
at the end of the first year) of not less than 80 per-
cent for each of the 3 school years preceding submis-
sion of the grant application. 
‘‘(e) REQUIREMENTS.—The Secretary may award a 
grant under this section to an eligible school of nursing 
only if the school gives assurances satisfactory to the Sec-
retary that, for each school year for which the grant is 
awarded, the school will comply with the following: 
‘‘(1) The school will maintain a passage rate on 
the National Council Licensure Examination for 
Registered Nurses of not less than 80 percent. 
‘‘(2) The school will maintain a graduation rate 
(as described in subsection (d)(3)) of not less than 
80 percent. 
‘‘(3)(A) Subject to subparagraphs (B) and (C), 
the first-year enrollment of full-time nursing stu-
dents in the school will exceed such enrollment for 
the preceding school year by 5 percent or 5 students, 
whichever is greater. 
‘‘(B) Subparagraph (A) does not apply to the 
first school year for which a school receives a grant 
under this section. 
‘‘(C) With respect to any school year, the Sec-
retary may waive application of subparagraph (A) 
if—
‘‘(i) the physical facilities at the school in-
volved limit the school from enrolling additional 
students; or 
‘‘(ii) the school has increased enrollment in 
the school (as described in subparagraph (A)) 
for each of the 2 preceding school years. 
‘‘(4) Not later than 1 year after receipt of the 
grant, the school will formulate and implement a 
plan to accomplish at least 2 of the following: 
‘‘(A) Establishing or significantly expand-
ing an accelerated baccalaureate degree nursing 
program designed to graduate new nurses in 12 
to 18 months. 
‘‘(B) 
Establishing 
cooperative 
intradisciplinary education among schools of 
nursing with a view toward shared use of tech-
nological resources, including information tech-
nology. 
‘‘(C) Establishing cooperative interdiscipli-
nary training between schools of nursing and 
schools of allied health, medicine, dentistry, os-
teopathy, optometry, podiatry, pharmacy, public 
health, or veterinary medicine, including train-
ing for the use of the interdisciplinary team ap-
proach to the delivery of health services.
‘‘(D) Integrating core competencies on evi-
dence-based practice, quality improvements, and 
patient-centered care. 
‘‘(E) Increasing admissions, enrollment, 
and retention of qualified individuals who are 
financially disadvantaged. 
‘‘(F) Increasing enrollment of minority and 
diverse student populations. 
‘‘(G) Increasing enrollment of new grad-
uate baccalaureate nursing students in graduate 
programs that educate nurse faculty members. 
‘‘(H) Developing post-baccalaureate resi-
dency programs to prepare nurses for practice 
in specialty areas where nursing shortages are 
most severe. 
‘‘(I) Increasing integration of geriatric con-
tent into the core curriculum. 
‘‘(J) Partnering with economically dis-
advantaged communities to provide nursing 
education. 
‘‘(K) Expanding the ability of nurse man-
aged health centers to provide clinical education 
training sites to nursing students. 
‘‘(5) The school will submit an annual report to 
the Secretary that includes updated information on
the school with respect to student enrollment, stu-
dent retention, graduation rates, passage rates on 
the National Council Licensure Examination for 
Registered Nurses, the number of graduates em-
ployed as nursing faculty or nursing care providers 
within 12 months of graduation, and the number of 
students who are accepted into graduate programs 
for further nursing education. 
‘‘(6) The school will allow the Secretary to 
make on-site inspections, and will comply with the 
Secretary’s requests for information, to determine 
the extent to which the school is complying with the 
requirements of this section. 
‘‘(g) REPORTS TO CONGRESS.—The Secretary shall 
evaluate the results of grants under this section and sub-
mit to the Congress— 
‘‘(1) not later than 18 months after the date of 
the enactment of this section, an interim report on 
such results; and 
‘‘(2) not later than the end of fiscal year 2007, 
a final report on such results. 
‘‘(h) APPLICATION.—To seek a grant under this sec-
tion, a school nursing shall submit an application to the 
Secretary at such time, in such manner, and containing