SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Home Healthcare 
Nurse Promotion Act of 2009’’. 
SEC. 2. FINDINGS AND PURPOSE. 
(a) FINDINGS.—Congress makes the following find-
ings: 
(1) There is a significant shortage of home 
healthcare nurses, which is harming individuals’ ac-
cess to cost-effective home healthcare, particularly 
among underserved and high-risk populations. A re-
cent survey found that 59 percent of visiting nurse 
associations indicated they must decline patient re-
ferrals on a weekly basis. 
(2) The increasing aging population, prevalence 
of chronic disease, and strong preference by individ-
uals to live independently at home as long as pos-
sible will create an unprecedented demand for home- 
based care during the next several decades. By 
2020, home health utilization is projected to increase 
by 36 percent. 
(3) The demand for home healthcare nurses is 
projected to increase by 109 percent by 2020, com-
pared to 37 percent for hospital nurses. 
(4) An estimated 1,000,000 new registered 
nurses will be needed by 2016 to fill new demand for 
nurses and replace retirees. 
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(5) Visiting nurse associations have been shown 
to lower costs for high-cost patient populations. Yet 
because they provide a substantial amount of un-
compensated care, they are increasingly unable to 
compete for nurses in a national nursing shortage 
environment. 
(6) A recent survey by the Visiting Nurses As-
sociation of America found that— 
(A) staff nursing rate shortages average 
around 10 percent; 
(B) 81 percent of visiting nurse associa-
tions indicate that salary limitations are the 
number one barrier to recruitment; and 
(C) 22 percent of visiting nurse associa-
tions indicate that their local hospital offers sal-
aries $10,000 greater than they are able to 
offer. 
(b) PURPOSE.—The purpose of this Act is to increase 
home health care services, particularly for underserved 
and at-risk populations, by— 
(1) assisting visiting nurse associations and 
other non-profit home health agencies to improve 
training and workforce development for home 
healthcare nurses; 
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(2) promoting and facilitating academic-practice 
collaborations; and 
(3) improving recruitment and retention of 
home healthcare nurses. 
SEC. 3. DEFINING VISITING NURSE ASSOCIATION. 
Section 801 of the Public Health Service Act (42 
U.S.C. 296) is amended by adding at the end the following 
new paragraph: 
‘‘(16) VISITING
NURSE
ASSOCIATION.—The 
term ‘visiting nurse association’ means a home 
health agency that— 
‘‘(A) has a participation agreement in ef-
fect under section 1866 of the Social Security 
Act; 
‘‘(B) is a nonprofit entity exempt from tax-
ation under section 501(c)(3) of the Internal 
Revenue Code of 1986; 
‘‘(C) is organized and participating under 
title XVIII of the Social Security Act as a pro-
vider of services separately from any other pro-
vider of services under such title; and 
‘‘(D) is governed by a board of directors 
and all members of the board (excluding the 
head of the agency in any case in which the 
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head of the agency is a board member) serve on 
such board on an exclusively volunteer basis.’’. 
SEC. 4. HOME HEALTH TRAINING AND LOAN FORGIVENESS 
PROGRAMS. 
(a) HOME HEALTH NURSE TRAINING PROGRAMS.— 
Part D of title VIII of the Public Health Service Act (42 
U.S.C. 296p) is amended by adding at the end the fol-
lowing new sections: 
‘‘SEC. 832. HOME HEALTH NURSE TRAINING PROGRAM 
GRANTS. 
‘‘(a) IN GENERAL.—The Secretary may make grants 
under this section to visiting nurse associations for the 
purpose of providing training in home health care to 
nurses who— 
‘‘(1) are hired by a visiting nurse association to 
provide home health care; and 
‘‘(2) have no recent nursing work experience in 
home health care. 
‘‘(b) PRIORITY
FOR
GRANTS.—When awarding 
grants under subsection (a), the Secretary shall give pri-
ority to visiting nurse associations that provide medically- 
necessary home health care to individuals who request 
home health services (as defined in section 1861(m) of the 
Social Security Act) from such associations, regardless of 
ability to pay. 
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‘‘SEC. 833. PILOT PROGRAM FOR HOME HEALTH TRAINING 
AT SCHOOLS OF NURSING. 
‘‘(a) IN GENERAL.—Not later than the last day of 
the 90-day period beginning on the date of enactment of 
this section, the Secretary shall establish a pilot program 
to make grants to a number (to be determined by the Sec-
retary, but to be not less than five and not more than 
10) of accredited schools of nursing that have entered into 
partnerships with visiting nurse associations for the pur-
pose of developing and implementing a curriculum on 
home health care at such schools. 
‘‘(b) APPLICATION.—In order to qualify for a grant 
under subsection (a), a school of nursing must submit an 
application to the Secretary— 
‘‘(1) demonstrating that the school has estab-
lished a partnership with a visiting nurse association 
as required in subsection (a); and 
‘‘(2) containing— 
‘‘(A) a description of how the school and 
the association will work collaboratively to de-
velop and implement a curriculum on home 
health care for the students at the school; 
‘‘(B) a description of how academic-prac-
tice collaboration will occur, such as— 
‘‘(i) utilizing visiting nurse faculty 
from the visiting nurse association; and 
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