In the Senate of the United States,
July 22, 2002.
Resolved, That the bill from the House of Representa-
tives (H.R. 3487) entitled ‘‘An Act to amend the Public Serv-
ice Act with respect to health professions programs regarding
the field of nursing.’’, do pass with the following
AMENDMENT:
Strike out all after the enacting clause and insert:
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Nurse Reinvestment
Act’’.
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SEC. 2. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
TITLE I—NURSE RECRUITMENT
Sec. 101. Definitions.
Sec. 102. Public service announcements regarding the nursing profession.
Sec. 103. National Nurse Service Corps.
TITLE II—NURSE RETENTION
Sec. 201. Building career ladders and retaining quality nurses.
Sec. 202. Comprehensive geriatric education.
Sec. 203. Nurse faculty loan program.
Sec. 204. Reports by General Accounting Office.
TITLE I—NURSE RECRUITMENT
SEC. 101. DEFINITIONS.
Section 801 of the Public Health Service Act (42
U.S.C. 296) is amended by adding at the end the following:
‘‘(9) 
AMBULATORY
SURGICAL
CENTER.—The
term ‘ambulatory surgical center’ has the meaning
applicable to such term under title XVIII of the So-
cial Security Act.
‘‘(10) FEDERALLY
QUALIFIED
HEALTH
CEN-
TER.—The term ‘Federally qualified health center’
has the meaning given such term under section
1861(aa)(4) of the Social Security Act.
‘‘(11) 
HEALTH
CARE
FACILITY.—The 
term
‘health care facility’ means an Indian Health Service
health center, a Native Hawaiian health center, a hos-
pital, a Federally qualified health center, a rural
health clinic, a nursing home, a home health agency,
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a hospice program, a public health clinic, a State or
local department of public health, a skilled nursing
facility, an ambulatory surgical center, or any other
facility designated by the Secretary.
‘‘(12) HOME HEALTH AGENCY.—The term ‘home
health agency’ has the meaning given such term in
section 1861(o) of the Social Security Act.
‘‘(13) HOSPICE
PROGRAM.—The term ‘hospice
program’ has the meaning given such term in section
1861(dd)(2) of the Social Security Act.
‘‘(14) RURAL HEALTH CLINIC.—The term ‘rural
health clinic’ has the meaning given such term in sec-
tion 1861(aa)(2) of the Social Security Act.
‘‘(15) SKILLED
NURSING
FACILITY.—The term
‘skilled nursing facility’ has the meaning given such
term in section 1819(a) of the Social Security Act.’’.
SEC. 102. PUBLIC SERVICE ANNOUNCEMENTS REGARDING
THE NURSING PROFESSION.
Title VIII of the Public Health Service Act (42 U.S.C.
296 et seq.) is amended by adding at the end the following:
‘‘PART H—PUBLIC SERVICE ANNOUNCEMENTS
‘‘SEC. 851. PUBLIC SERVICE ANNOUNCEMENTS.
‘‘(a) IN GENERAL.—The Secretary shall develop and
issue public service announcements that advertise and pro-
mote the nursing profession, highlight the advantages and
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rewards of nursing, and encourage individuals to enter the
nursing profession.
‘‘(b) METHOD.—The public service announcements de-
scribed in subsection (a) shall be broadcast through appro-
priate media outlets, including television or radio, in a
manner intended to reach as wide and diverse an audience
as possible.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There are
authorized to be appropriated to carry out this section such
sums as may be necessary for each of fiscal years 2003
through 2007.
‘‘SEC. 852. STATE AND LOCAL PUBLIC SERVICE ANNOUNCE-
MENTS.
‘‘(a) IN GENERAL.—The Secretary may award grants
to eligible entities to support State and local advertising
campaigns through appropriate media outlets to promote
the nursing profession, highlight the advantages and re-
wards of nursing, and encourage individuals from dis-
advantaged backgrounds to enter the nursing profession.
‘‘(b) USE OF FUNDS.—An eligible entity that receives
a grant under subsection (a) shall use funds received
through such grant to acquire local television and radio
time, place advertisements in local newspapers, or post in-
formation on billboards or on the Internet in a manner in-
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tended to reach as wide and diverse an audience as possible,
in order to—
‘‘(1) advertise and promote the nursing profes-
sion;
‘‘(2) promote nursing education programs;
‘‘(3) inform the public of financial assistance re-
garding such education programs;
‘‘(4) highlight individuals in the community who
are practicing nursing in order to recruit new nurses;
or
‘‘(5) provide any other information to recruit in-
dividuals for the nursing profession.
‘‘(c) LIMITATION.—An eligible entity that receives a
grant under subsection (a) shall not use funds received
through such grant to advertise particular employment op-
portunities.
‘‘(d) AUTHORIZATION
OF APPROPRIATIONS.—There
are authorized to be appropriated to carry out this section
such sums as may be necessary for each of fiscal years 2003
through 2007.’’.
SEC. 103. NATIONAL NURSE SERVICE CORPS.
(a) LOAN REPAYMENT PROGRAM.—Section 846(a) of
the Public Health Service Act (42 U.S.C. 297n(a)) is
amended—
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(1) in paragraph (3), by striking ‘‘in an Indian
Health Service health center’’ and all that follows to
the semicolon and inserting ‘‘at a health care facility
with a critical shortage of nurses’’; and
(2) by adding at the end the following: ‘‘After
fiscal year 2007, the Secretary may not, pursuant to
any agreement entered into under this subsection, as-
sign a nurse to any private entity unless that entity
is nonprofit.’’.
(b) ESTABLISHMENT OF SCHOLARSHIP PROGRAM.—
Section 846 of the Public Health Service Act (42 U.S.C.
297n) is amended—
(1) in the heading for the section, by striking
‘‘LOAN REPAYMENT PROGRAM’’ and inserting ‘‘LOAN
REPAYMENT AND SCHOLARSHIP PROGRAMS’’;
(2) by redesignating subsections (d), (f), (g), and
(h) as subsections (f), (h), (i), and (g), respectively;
(3) by transferring subsections (f) and (g) (as so
redesignated) from their current placements, by in-
serting subsection (f) after subsection (e), and by in-
serting subsection (g) after subsection (f) (as so in-
serted); and
(4) by inserting after subsection (c) the following
subsection:
‘‘(d) SCHOLARSHIP PROGRAM.—
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‘‘(1) IN GENERAL.—The Secretary shall (for fis-
cal years 2003 and 2004) and may (for fiscal years
thereafter) carry out a program of entering into con-
tracts with eligible individuals under which such in-
dividuals agree to serve as nurses for a period of not
less than 2 years at a health care facility with a crit-
ical shortage of nurses, in consideration of the Federal
Government agreeing to provide to the individuals
scholarships for attendance at schools of nursing.
‘‘(2) ELIGIBLE INDIVIDUALS.—In this subsection,
the term ‘eligible individual’ means an individual
who is enrolled or accepted for enrollment as a full-
time or part-time student in a school of nursing.
‘‘(3) SERVICE REQUIREMENT.—
‘‘(A) IN GENERAL.—The Secretary may not
enter into a contract with an eligible individual
under this subsection unless the individual
agrees to serve as a nurse at a health care facil-
ity with a critical shortage of nurses for a period
of full-time service of not less than 2 years, or
for a period of part-time service in accordance
with subparagraph (B).
‘‘(B) PART-TIME SERVICE.—An individual
may complete the period of service described in
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subparagraph (A) on a part-time basis if the in-
dividual has a written agreement that—
‘‘(i) is entered into by the facility and
the individual and is approved by the Sec-
retary; and
‘‘(ii) provides that the period of obli-
gated service will be extended so that the ag-
gregate amount of service performed will
equal the amount of service that would be
performed through a period of full-time
service of not less than 2 years.
‘‘(4) APPLICABILITY OF CERTAIN PROVISIONS.—
The provisions of subpart III of part D of title III
shall, except as inconsistent with this section, apply
to the program established in paragraph (1) in the
same manner and to the same extent as such provi-
sions apply to the National Health Service Corps
Scholarship Program established in such subpart.’’.
(c) PREFERENCE.—Section 846(e) of the Public Health
Service Act (42 U.S.C. 297n(e)) is amended by striking
‘‘under subsection (a)’’ and all that follows through the pe-
riod and inserting ‘‘under subsection (a) or (d), the Sec-
retary shall give preference to qualified applicants with the
greatest financial need.’’.
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(d) REPORTS.—Subsection (h) of section 846 of the
Public Health Service Act (42 U.S.C. 297n) (as redesig-
nated by subsection (b)(2)) is amended to read as follows:
‘‘(h) REPORTS.—Not later than 18 months after the
date of enactment of the Nurse Reinvestment Act, and annu-
ally thereafter, the Secretary shall prepare and submit to
the Congress a report describing the programs carried out
under this section, including statements regarding—
‘‘(1) the number of enrollees, scholarships, loan
repayments, and grant recipients;
‘‘(2) the number of graduates;
‘‘(3) the amount of scholarship payments and
loan repayments made;
‘‘(4) which educational institution the recipients
attended;
‘‘(5) the number and placement location of the
scholarship and loan repayment recipients at health
care facilities with a critical shortage of nurses;
‘‘(6) the default rate and actions required;
‘‘(7) the amount of outstanding default funds of
both the scholarship and loan repayment programs;
‘‘(8) to the extent that it can be determined, the
reason for the default;
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‘‘(9) the demographics of the individuals partici-
pating in the scholarship and loan repayment pro-
grams;
‘‘(10) justification for the allocation of funds be-
tween the scholarship and loan repayment programs;
and
‘‘(11) an evaluation of the overall costs and bene-
fits of the programs.’’.
(e) FUNDING.—Subsection (i) of section 846 of the
Public Health Service Act (42 U.S.C. 297n) (as redesig-
nated by subsection (b)(2)) is amended to read as follows:
‘‘(i) FUNDING.—
‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—For
the purpose of payments under agreements entered
into under subsection (a) or (d), there are authorized
to be appropriated such sums as may be necessary for
each of fiscal years 2003 through 2007.
‘‘(2) ALLOCATIONS.—Of the amounts appro-
priated under paragraph (1), the Secretary may, as
determined appropriate by the Secretary, allocate
amounts between the program under subsection (a)
and the program under subsection (d).’’.
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TITLE II—NURSE RETENTION
SEC. 201. BUILDING CAREER LADDERS AND RETAINING
QUALITY NURSES.
Section 831 of the Public Health Service Act (42
U.S.C. 296p) is amended to read as follows:
‘‘SEC. 831. NURSE EDUCATION, PRACTICE, AND RETENTION
GRANTS.
‘‘(a) EDUCATION PRIORITY AREAS.—The Secretary
may award grants to or enter into contracts with eligible
entities for—
‘‘(1) expanding the enrollment in baccalaureate
nursing programs;
‘‘(2) developing and implementing internship
and residency programs to encourage mentoring and
the development of specialties; or
‘‘(3) providing education in new technologies, in-
cluding distance learning methodologies.
‘‘(b) PRACTICE PRIORITY AREAS.—The Secretary may
award grants to or enter into contracts with eligible entities
for—
‘‘(1) establishing or expanding nursing practice
arrangements in noninstitutional settings to dem-
onstrate methods to improve access to primary health
care in medically underserved communities;
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‘‘(2) providing care for underserved populations
and other high-risk groups such as the elderly, indi-
viduals with HIV–AIDS, substance abusers, the home-
less, and victims of domestic violence;
‘‘(3) providing managed care, quality improve-
ment, and other skills needed to practice in existing
and emerging organized health care systems; or
‘‘(4) developing cultural competencies among
nurses.
‘‘(c) RETENTION PRIORITY AREAS.—The Secretary
may award grants to and enter into contracts with eligible
entities to enhance the nursing workforce by initiating and
maintaining nurse retention programs pursuant to para-
graph (1) or (2).
‘‘(1) 
GRANTS
FOR
CAREER
LADDER
PRO-
GRAMS.—The Secretary may award grants to and
enter into contracts with eligible entities for
programs—
‘‘(A) to promote career advancement for
nursing personnel in a variety of training set-
tings, cross training or specialty training among
diverse population groups, and the advancement
of individuals including to become professional
nurses, advanced education nurses, licensed prac-
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tical nurses, certified nurse assistants, and home
health aides; and
‘‘(B) to assist individuals in obtaining edu-
cation and training required to enter the nurs-
ing profession and advance within such profes-
sion, such as by providing career counseling and
mentoring.
‘‘(2) ENHANCING PATIENT CARE DELIVERY SYS-
TEMS.—
‘‘(A) GRANTS.—The Secretary may award
grants to eligible entities to improve the reten-
tion of nurses and enhance patient care that is
directly related to nursing activities by enhanc-
ing collaboration and communication among
nurses and other health care professionals, and
by promoting nurse involvement in the organiza-
tional and clinical decisionmaking processes of a
health care facility.
‘‘(B) PREFERENCE.—In making awards of
grants under this paragraph, the Secretary shall
give a preference to applicants that have not pre-
viously received an award under this paragraph.
‘‘(C) CONTINUATION
OF
AN
AWARD.—The
Secretary shall make continuation of any award
under this paragraph beyond the second year of
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such award contingent on the recipient of such
award having demonstrated to the Secretary
measurable and substantive improvement in
nurse retention or patient care.
‘‘(d) OTHER PRIORITY AREAS.—The Secretary may
award grants to or enter into contracts with eligible entities
to address other areas that are of high priority to nurse
education, practice, and retention, as determined by the
Secretary.
‘‘(e) PREFERENCE.—For purposes of any amount of
funds appropriated to carry out this section for fiscal year
2003, 2004, or 2005 that is in excess of the amount of funds
appropriated to carry out this section for fiscal year 2002,
the Secretary shall give preference to awarding grants or
entering into contracts under subsections (a)(2) and (c).
‘‘(f) REPORT.—The Secretary shall submit to the Con-
gress before the end of each fiscal year a report on the grants
awarded and the contracts entered into under this section.
Each such report shall identify the overall number of such
grants and contracts and provide an explanation of why
each such grant or contract will meet the priority need of
the nursing workforce.
‘‘(g) ELIGIBLE ENTITY.—For purposes of this section,
the term ‘eligible entity’ includes a school of nursing, a
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health care facility, or a partnership of such a school and
facility.
‘‘(h) AUTHORIZATION
OF APPROPRIATIONS.—There
are authorized to be appropriated to carry out this section
such sums as may be necessary for each of fiscal years 2003
through 2007.’’.
SEC. 202. COMPREHENSIVE GERIATRIC EDUCATION.
(a) COMPREHENSIVE GERIATRIC EDUCATION.—Title
VIII of the Public Health Service Act (42 U.S.C. 296 et
seq.) (as amended by section 102) is amended by adding
at the end the following:
‘‘PART I—COMPREHENSIVE GERIATRIC
EDUCATION
‘‘SEC. 855. COMPREHENSIVE GERIATRIC EDUCATION.
‘‘(a) PROGRAM AUTHORIZED.—The Secretary shall
award grants to eligible entities to develop and implement,
in coordination with programs under section 753, programs
and initiatives to train and educate individuals in pro-
viding geriatric care for the elderly.
‘‘(b) USE OF FUNDS.—An eligible entity that receives
a grant under subsection (a) shall use funds under such
grant to—
‘‘(1) provide training to individuals who will
provide geriatric care for the elderly;
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‘‘(2) develop and disseminate curricula relating
to the treatment of the health problems of elderly indi-
viduals;
‘‘(3) train faculty members in geriatrics; or
‘‘(4) provide continuing education to individuals
who provide geriatric care.
‘‘(c) APPLICATION.—An eligible entity desiring a
grant under subsection (a) shall submit an application to
the Secretary at such time, in such manner, and containing
such information as the Secretary may reasonably require.
‘‘(d) ELIGIBLE ENTITY.—For purposes of this section,
the term ‘eligible entity’ includes a school of nursing, a
health care facility, a program leading to certification as
a certified nurse assistant, a partnership of such a school
and facility, or a partnership of such a program and facil-
ity.
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There are
authorized to be appropriated to carry out this section such
sums as may be necessary for each of fiscal years 2003
through 2007.’’.
(b) TECHNICAL AMENDMENT.—Section 753(a)(1) of
the Public Health Service Act (42 U.S.C. 294c) is amended
by striking ‘‘, and section 853(2),’’ and inserting ‘‘, and
section 801(2),’’.
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SEC. 203. NURSE FACULTY LOAN PROGRAM.
Part E of title VIII of the Public Health Service Act
(42 U.S.C. 297a et seq.) is amended by inserting after sec-
tion 846 the following:
‘‘NURSE FACULTY LOAN PROGRAM
‘‘SEC. 846A. (a) ESTABLISHMENT.—The Secretary,
acting through the Administrator of the Health Resources
and Services Administration, may enter into an agreement
with any school of nursing for the establishment and oper-
ation of a student loan fund in accordance with this section,
to increase the number of qualified nursing faculty.
‘‘(b) AGREEMENTS.—Each agreement entered into
under subsection (a) shall—
‘‘(1) provide for the establishment of a student
loan fund by the school involved;
‘‘(2) provide for deposit in the fund of—
‘‘(A) the Federal capital contributions to the
fund;
‘‘(B) an amount equal to not less than one-
ninth of such Federal capital contributions, con-
tributed by such school;
‘‘(C) collections of principal and interest on
loans made from the fund; and
‘‘(D) any other earnings of the fund;
‘‘(3) provide that the fund will be used only for
loans to students of the school in accordance with sub-
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section (c) and for costs of collection of such loans and
interest thereon;
‘‘(4) provide that loans may be made from such
fund only to students pursuing a full-time course of
study or, at the discretion of the Secretary, a part-
time course of study in an advanced degree program
described in section 811(b); and
‘‘(5) contain such other provisions as are nec-
essary to protect the financial interests of the United
States.
‘‘(c) LOAN PROVISIONS.—Loans from any student loan
fund established by a school pursuant to an agreement
under subsection (a) shall be made to an individual on such
terms and conditions as the school may determine, except
that—
‘‘(1) such terms and conditions are subject to
any conditions, limitations, and requirements pre-
scribed by the Secretary;
‘‘(2) in the case of any individual, the total of
the loans for any academic year made by schools of
nursing from loan funds established pursuant to
agreements under subsection (a) may not exceed
$30,000, plus any amount determined by the Sec-
retary on an annual basis to reflect inflation;
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‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There are
authorized to be appropriated to carry out this section such
sums as may be necessary for each of fiscal years 2003
through 2007.’’.
SEC. 204. REPORTS BY GENERAL ACCOUNTING OFFICE.
(a) NATIONAL VARIATIONS.—Not later than 4 years
after the date of the enactment of this Act, the Comptroller
General of the United States shall conduct a survey to deter-
mine national variations in the nursing shortage at hos-
pitals, nursing homes, and other health care providers, and
submit a report, including recommendations, to the Con-
gress on Federal remedies to ease nursing shortages. The
Comptroller General shall submit to the Congress this report
describing the findings relating to ownership status and as-
sociated remedies.
(b) HIRING DIFFERENCES AMONG CERTAIN PRIVATE
ENTITIES.—The Comptroller General of the United States
shall conduct a study to determine differences in the hiring
of nurses by nonprofit private entities as compared to the
hiring of nurses by private entities that are not nonprofit.
In carrying out the study, the Comptroller General shall
determine the effect of the inclusion of private entities that
are not nonprofit in the program under section 846 of the
Public Health Service Act. Not later than 4 years after the
date of the enactment of this Act, the Comptroller General
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shall submit to the Congress a report describing the findings
of the study.
(c) NURSING SCHOLARSHIPS.—The Comptroller Gen-
eral of the United States shall conduct an evaluation of
whether the program carried out under section 846(d) of
the Public Health Service Act has demonstrably increased
the number of applicants to schools of nursing and, not later
than 4 years after the date of the enactment of this Act,
submit a report to the Congress on the results of such eval-
uation.
Attest:
Secretary.