Title: Title VIII Nursing Workforce Reauthorization Act of 2019
Policy area: Health

Summary:
Title VIII Nursing Workforce Reauthorization Act of 2019  This bill expands and reauthorizes through FY2024 specified nursing workforce development programs. Specifically, the bill reauthorizes (1) loan repayment and scholarships for nurses; (2) loans for nursing faculty development; (3) advanced education nursing grants; (4) grants for increasing nursing workforce diversity; and (5) nurse education, practice, quality, and retention grants.  Eligibility for nurse education, practice, quality, and retention grants is expanded to include nurse-managed health clinics that provide primary care to underserved communities. Further, grants for nursing career ladder programs are expanded to (1) promote career advancement for individuals to become registered nurses or advanced education nurses and (2) support internships and residency programs that encourage mentoring and the development of specialties.  In addition, eligibility for advanced education nursing grants is expanded to include education of clinical nurse leaders in combined registered nurse graduate degree programs. Clinical nurse leaders are advanced generalist clinicians who apply research and coordinate care to improve outcomes for patients. Eligibility is also extended to clinical nurse specialist programs that provide registered nurses with full-time clinical nurse specialist education that qualifies participating nurses to provide a full range of care.  The bill also revises specified grant reporting and program evaluation requirements.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 728 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 728

To amend title VIII of the Public Health Service Act to extend advanced 
education nursing grants to support clinical nurse specialist programs, 
                        and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 23, 2019

   Mr. Joyce of Ohio (for himself, Ms. Gabbard, Mr. Rodney Davis of 
    Illinois, Ms. Bonamici, Ms. Matsui, Ms. Castor of Florida, Mr. 
 McKinley, and Ms. Underwood) introduced the following bill; which was 
            referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
To amend title VIII of the Public Health Service Act to extend advanced 
education nursing grants to support clinical nurse specialist programs, 
                        and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Title VIII Nursing 
Workforce Reauthorization Act of 2019''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. General provisions.
Sec. 3. Nurse practitioners, nurse midwives, nurse anesthetists, and 
                            other advanced education nurses.
Sec. 4. Increasing nursing workforce diversity.
Sec. 5. Strengthening capacity for basic nurse education and practice.
Sec. 6. Student loans.
Sec. 7. National Advisory Council on Nurse Education and Practice.
Sec. 8. Other provisions.

SEC. 2. GENERAL PROVISIONS.

    (a) Application.--Section 802(c) of the Public Health Service Act 
(42 U.S.C. 296a(c)) is amended by striking ``shall address relevant 
national nursing needs that the project will meet'' and inserting 
``shall address relevant national nursing needs that the project will 
address and how the project aligns with the national nursing service 
goals referred to in section 806(a)''.
    (b) Use of Funds.--Section 803 of the Public Health Service Act (42 
U.S.C. 296b) is amended by adding at the end the following:
    ``(c) Supplement Not Supplant.--Funds awarded as a grant under this 
title for a project or activity shall be used to supplement, not 
supplant, the non-Federal funds that would otherwise be made available 
for such project or activity.''.
    (c) Generally Applicable Provisions.--Section 806 of the Public 
Health Service Act (42 U.S.C. 296e) is amended--
            (1) in subsection (b), by amending paragraph (2) to read as 
        follows:
            ``(2) Evaluations.--The Secretary shall establish 
        procedures to ensure the annual evaluation of programs and 
        projects operated by recipients of grants under this title. 
        Such procedures shall ensure that continued funding for such 
        programs and projects will be conditioned upon the submission 
        of--
                    ``(A) data demonstrating that satisfactory progress 
                has been made by the program or project in meeting the 
                performance outcome standards (as described in section 
                802) of such program or project; and
                    ``(B) a detailed description of activities 
                conducted by such program or project to meet such 
                performance outcome standards.'';
            (2) in subsection (e)(2), by inserting ``, and have 
        relevant expertise and experience'' after ``who are not 
        officers or employees of the Federal Government''; and
            (3) by adding at the end the following:
    ``(i) Annual Report on Nursing Workforce Programs.--Annually, the 
Secretary shall submit to the Committee on Health, Education, Labor, 
and Pensions of the Senate, and the Committee on Energy and Commerce of 
the House of Representatives, a report containing an assessment of the 
programs and activities of the Department of Health and Human Services 
related to enhancing the nursing workforce, including the extent to 
which programs and activities under this title meet identified goals 
and performance measures developed for the respective programs and 
activities.''.

SEC. 3. NURSE PRACTITIONERS, NURSE MIDWIVES, NURSE ANESTHETISTS, AND 
              OTHER ADVANCED EDUCATION NURSES.

    Section 811 of the Public Health Service Act (42 U.S.C. 296j) is 
amended--
            (1) in subsection (b)--
                    (A) by striking ``R.N./Master's'' and inserting 
                ``R.N./graduate''; and
                    (B) by inserting ``clinical nurse leaders,'' before 
                ``or public health nurses'';
            (2) by redesignating subsections (f) and (g) as subsections 
        (g) and (h), respectively;
            (3) by inserting after subsection (e) the following new 
        subsection:
    ``(f) Authorized Clinical Nurse Specialist Programs.--Clinical 
nurse specialist programs eligible for support under this section are 
education programs that--
            ``(1) provide registered nurses with full-time clinical 
        nurse specialist education; and
            ``(2) have as their objective the education of clinical 
        nurse specialists who will upon completion of such a program be 
        qualified to effectively provide care through the wellness and 
        illness continuum to inpatients and outpatients experiencing 
        acute and chronic illness.''; and
            (4) by adding at the end the following:
    ``(i) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $74,581,000 for each of fiscal 
years 2020 through 2024.''.

SEC. 4. INCREASING NURSING WORKFORCE DIVERSITY.

    Section 821 of the Public Health Service Act (42 U.S.C. 296m) is 
amended by adding at the end the following:
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $17,343,000 for each of fiscal 
years 2020 through 2024.''.

SEC. 5. STRENGTHENING CAPACITY FOR BASIC NURSE EDUCATION AND PRACTICE.

    (a) Nurse Education, Practice, Quality, and Retention Grants.--
Section 831 of the Public Health Service Act (42 U.S.C. 296p) is 
amended--
            (1) in the section heading, by striking ``and quality'' and 
        inserting ``quality, and retention'';
            (2) in subsection (b), by amending paragraph (2) to read as 
        follows:
            ``(2) providing care for underserved populations and high-
        risk groups, which may include the elderly, individuals with 
        HIV/AIDS, individuals with mental health or substance use 
        disorders, individuals who are homeless, and victims and 
        survivors of domestic violence;'';
            (3) in subsection (c), by amending paragraph (1) to read as 
        follows:
            ``(1) Grants for career ladder programs.--The Secretary may 
        award grants to and enter into contracts with eligible entities 
        for programs--
                    ``(A) to promote career advancement for--
                            ``(i) nursing personnel in a variety of 
                        training settings, cross training or specialty 
                        training among diverse population groups, and 
                        the advancement of individuals, including to 
                        become professional registered nurses, advanced 
                        practice registered nurses, and nurses with 
                        graduate nursing education; and
                            ``(ii) individuals, including licensed 
                        practical nurses, licensed vocational nurses, 
                        certified nurse assistants, and diploma degree 
                        or associate degree nurses, to become 
                        baccalaureate-prepared registered nurses or 
                        nurses with graduate nursing education;
                    ``(B) to assist individuals in obtaining education 
                and training required to enter the nursing profession 
                and advance within such profession, such as by 
                providing career counseling and mentoring; and
                    ``(C) to develop and implement internships, 
                accredited fellowships, and accredited residency 
                programs in collaboration with one or more accredited 
                schools of nursing to encourage mentoring and 
                development of specialties.'';
            (4) by striking subsection (e) (relating to preference);
            (5) by redesignating subsections (f) through (h) as 
        subsections (e) and (g), respectively;
            (6) in subsection (e), as so redesignated, by striking 
        ``The Secretary shall submit to the Congress before the end of 
        each fiscal year a'' and inserting ``As part of the report on 
        nursing workforce programs described in section 806(i), the 
        Secretary shall'';
            (7) by amending subsection (f), as redesignated by 
        paragraph (5), to read as follows:
    ``(f) Definitions.--For purposes of this section:
            ``(1) Eligible entity.--The term `eligible entity' includes 
        an accredited school of nursing, a health care facility, a 
        partnership of such a school and facility, a federally 
        qualified health center, or a nurse-managed health clinic.
            ``(2) Nurse-managed health clinic.--The term `nurse-managed 
        health clinic' means a nurse-practice arrangement, managed by 
        advanced practice nurses, that provides primary care or 
        wellness services to underserved or vulnerable populations that 
        is associated with a school, college, university or department 
        of nursing, federally qualified health center, or independent 
        nonprofit health or social services agency.''; and
            (8) in subsection (g), as redesignated by paragraph (5), by 
        striking ``such sums as may be necessary for each of fiscal 
        years 2010 through 2014'' and inserting ``$41,913,000 for each 
        of fiscal years 2020 through 2024''.
    (b) Nurse Retention Grants.--Section 831A of the Public Health 
Service Act (42 U.S.C. 296p-1) is repealed.

SEC. 6. STUDENT LOANS.

    (a) Loan Repayment and Scholarship Programs.--Section 846 of the 
Public Health Service Act (42 U.S.C. 297n) is amended--
            (1) in subsection (b)(1), by striking ``he began such 
        practice'' and inserting ``the individual began such 
        practice'';
            (2) in subsection (d)(1), by striking ``(for fiscal years 
        2003 and 2004) and may (for fiscal years thereafter)'';
            (3) in subsection (h), in the matter preceding paragraph 
        (1), by striking ``Not later than'' through ``regarding'' and 
        inserting ``The annual report on nursing workforce programs, as 
        required by section 806(i), shall include information regarding 
        the programs carried out under this section, including''; and
            (4) in subsection (i)(1), by striking ``such sums as may be 
        necessary for each of fiscal years 2003 through 2007'' and 
        inserting ``$87,135,000 for each of fiscal years 2020 through 
        2024''.
    (b) Nurse Faculty Loan Program.--Section 846A of the Public Health 
Service Act (42 U.S.C. 297n-1) is amended by striking ``such sums as 
may be necessary for each of fiscal years 2010 through 2014'' and 
inserting ``$28,500,000 for each of fiscal years 2020 through 2024''.

SEC. 7. NATIONAL ADVISORY COUNCIL ON NURSE EDUCATION AND PRACTICE.

    Section 851 of the Public Health Service Act (42 U.S.C. 297t) is 
amended--
            (1) in subsection (b)(1)(A)(iv), by striking ``and nurse 
        anesthetists'' and inserting ``nurse anesthetists, and clinical 
        nurse specialists'';
            (2) in subsection (d), by amending paragraph (3) to read as 
        follows:
            ``(3) not later than 2 years after the date of enactment of 
        the Title VIII Nursing Workforce Reauthorization Act of 2019, 
        and every 2 years thereafter, prepare and submit to the 
        Secretary, the Committee on Health, Education, Labor, and 
        Pensions of the Senate, and the Committee on Energy and 
        Commerce of the House of Representatives, a report describing 
        the activities of the Council, including findings and 
        recommendations made by the Council concerning the activities 
        under this title.''; and
            (3) in subsection (g), by striking ``under this title'' and 
        inserting ``for carrying out parts B, C, and D of this title''.

SEC. 8. OTHER PROVISIONS.

    (a) Public Service Announcements.--Part G of title VIII of the 
Public Health Service Act (42 U.S.C. 297w et seq.) is repealed.
    (b) Funding.--Part I of title VIII of the Public Health Service Act 
(42 U.S.C. 298d) is repealed.
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