An Act to amend title VIII of the Public Health Service Act to provide for training increased numbers of nurses
PL 92-158 (H.R.8630), enacted 11/18/1971

85 STAT. ] 
PUBLIC LAW 92-158-NOV. 18, 1971 
465 
Public Law 92-158 
AN ACT 
November 18,1971 
To amend title VIII of the Public Health Service Act to provide for training 
[H. R. 8630] 
increased numbers of nurses. 
Be it enacted by the Senate mid Flo use of Representatives 
of the 
United States of America in Congress assembled^ 
SHORT T I T L E ; 
R E F E R E N C E S T O A C T 
Nurse Training 
Act of 1971. 
SECTION 1. (a) This Act may be cited as tlie "Nurse Training Act of 
1971''. 
(b) Whenever in this Act an amendment or repeal is expressed in 
terms of an amendment to, or repeal of, a section or other provision, 
the reference shall be considered to be made to a section or other pro-
vision of the Public Health Service Act. 
ss stat. 682. 
42 u s e 201 
note. 
CONSTRUCTION GRANTS 
SEC. 2. (a) AUTHORIZATION LEVEL.—Section 801 (42 U.S.C. 296(a)) 
8 2 stat. 78o. 
is amended to read as follows: 
''AUTHORIZATION OF APPROPRIATIONS FOR CONSTRUCTION GRANTS 
"SEC. 801. There are authorized to be appropriated for grants to 
assist in the construction of new facilities for collegiate, associate 
degree, or diploma schools of nursing, and for grants to assist in the 
replacement or rehabilitation of existing facilities for such schools, 
$85,000,000 for the fiscal year ending June 30, 1972, $40,000,000 for 
the fiscal year ending June 30, 1973, and $45,000,000 for the fiscal year 
ending June 30,19^4." 
(b) FEDERAL SHARE.— 
(1) Clause (A) of section 803(a) (42 U.S.C. 296b(a)) is 
78stat. 9ii. 
amended (A) by inserting " ( i ) " immediately before "for a proj-
ect" the first time it appears, (B) by striking out "and in the case 
of a grant" and inserting in lieu thereof "(ii)", (C) by inserting 
"and (iii) for a project for major remodeling or renovation of an 
existing facility where such project is required to meet an increase 
in student enrollment,'' immediately before "such amount", and 
(D) by striking out "66% per centum" and inserting in lieu 
thereof "75 per centum". 
(2) Clause (B) of such section is amended (A) by striking out 
"66% per centum" and inserting in lieu thereof "75 per centum" 
and (B) by striking out "50 per centum" and inserting in lieu 
thereof "67 per centum". 
(c) LOAN GUARANTEES.—Part A of this title VIII is amended by 
adding after section 808 (42 U.S.C. 296g) the following new section: 
8 2 stat. 78 3. 
u LOAN GUARANTEES AND INTEREST SUBSIDIES 
"SEC. 809. (a) In order to assist nonprofit private schools of nursing 
Nonprofit pri-
' 
• 
• 
p 
• • ^ 
p 
•-,• • 
1 1 - 1 
vate nursing 
to carry out construction projects tor training facilities, the Secretary schools. 
may, during the period beginning July 1, 1971, and ending with the 
close of June 30, 1974, guarantee (in accordance with this section and 
subject to subsection (f)) to non-Federal lenders making loans to such 
schools for such construction projects payment when due of the princi-
pal of and interest on any loan for construction of such facilities if the 
loan was made to a school which is eligible (as determined under 
regulations of the Secretary) for a grant under this part to assist a con-
struction project for such facilities. The Secretary may make commit-
466 
PUBLIC LAW 92-158-NOV. 18, 1971 
[85 STAT. 
Application, 
Recovery right. 
Fund. 
Appropriation. 
ments, on behalf of the United States, to make such loan guarantees 
prior to the making of such loans. No such loan guarantee (1) may, 
except under such special circumstances and under such conditions as 
are prescribed by regulations, apply to any amount which, when added 
to any grant for construction under this part or any other law of the 
United States, exceeds 90 per centum of the cost of construction of the 
project, or (2) may apply to more than 90 per centum of the loss of 
principal of and interest on the loan. 
"(b) In the case of any nonprofit private school of nursing which is 
eligible (as determined under regulations of the Secretary) for a grant 
under this part to assist a construction project for training facilities, 
and to whom a loan has been made by a non-Federal lender to assist it 
in carrying out such project, the Secretary, during the period begin-
ning July 1, 1971, and ending with the close of June 30, 1974, may, 
subject to subsection (f), pay to the holder of such loan (and for and on 
behalf of the school which received such loan) amounts sufficient to 
reduce by not to exceed 3 per centum per annum the net effective 
interest rate otherwise payable on such loan. 
"(c) A loan guarantee or interest subsidy payment may be made 
under this section only upon an application (submitted in such manner 
and containing such information as the Secretary may by regulations 
require) approved by the Secretary. The Secretary may not approve 
an application for a loan guarantee or interest subsidy payment unless 
he determines that the terms, conditions, security (if any), and sched-
ule and amount of repayments with respect to the loan are sufficient to 
protect the financial interests of the United States and are otherwise 
reasonable, including a determination that the rate of interest does not 
exceed such per centum per annum on the principal obligation out-
standing as the Secretary determines to be reasonable, taking into 
account the range of interest rates prevailing in the private market for 
similar loans and the risks assumed by the United States. The Secre-
tary may not approve an application for a loan guarantee, unless he 
determines that the loan would not be available on reasonable terms 
and conditions without the guarantee under this section. 
"(d) (1) The United States shall be entitled to recover from any 
school of nursing for whom a loan guarantee was made under this 
section the amount of any payment made pursuant to such guarantee, 
unless the Secretary for good cause waives such right of recovery; and, 
upon making any such payment, the United States shall be subrogated 
to all of the rights of the recipient of the payments with respect to 
which the guarantee was made. 
"(2) To the extent permitted by paragraph (3), any terms and 
conditions applicable to a loan guarantee under this section may be 
modified by the Secretary to the extent he determines it to be con-
sistent with the financial interest of the United States, 
"(3) Any loan guarantee made by the Secretary pursuant to this 
section shall be incontestable in the hands of an applicant on whose 
behalf such guarantee is made, and as to any person who makes or 
contracts to make a loan to such applicant in reliance thereon, except 
for fraud or misrepresentation on the part of such applicant or such 
other person. 
"(e) There is established in the Ti-easury a loan guarantee and 
interest subsidy fund (hereinafter in this subsection referred to as 
the 'fund') which shall be available to the Secretary without fiscal 
year limitation, in such amounts as may be specified from time to time 
in appropriation Acts, (1) to enable him to discharge his responsi-
bilities under guarantees issued by him under this section, and (2) 
for interest subsidy payments authorized by this section. There are 
authorized to be appropriated from time to time such amounts as 
85 STAT. ] 
PUBLIC LAW 92-158-NOV. 18, 1971 
467 
may be necessary to provide the sums required for the fund; except 
that the amount appropriated for interest subsidy payments may not 
exceed $1,000,000 in the fiscal year ending June 30, 1972, $2,000,000 
in the fiscal year ending June 30, 1973, and $4,000,000 in the fiscal 
year ending June 30, 1974. There shall also be deposited in the fund 
amounts received by the Secretary or other property or assets derived 
by him from his operations under this section, including any money 
derived from the sale of assets. If at any time the sums in the fund 
are insufficient to enable the Secretary to discharge his responsibilities 
under guarantees issued by him under this section or to make interest 
subsidy payments authorized by this section, he is authorized to issue 
to the Secretary of the Treasury notes or other obligations in such 
forms and denominations, bearing such maturities, and subject to such 
terms and conditions, as may be prescribed by the Secretary with the 
approval of the Secretary of the Treasury, but only in such amounts 
as may be specified from time to time in appropriation Acts. Such 
notes or other obligations shall bear interest at a rate determined by 
the Secretary of the Treasury, taking into consideration the current 
aveTage market yield on outstanding marketable obligations of the 
United States of comparable maturities during the month preceding 
the issuance of the notes or other obligations. The Secretary of the 
Treasury shall purchase any notes and other obligations issued here-
under and for that purpose he may use as a public debt transaction 
the proceeds from the sale of any securities issued under the Second 
Liberty Bond Act, and the purposes for which the securities may be 
^
^ ^
*
^
*
* ^*^' 
issued under that Act are extended to include any purchase of such 
3
1
* use 774,. 
notes and obligations. The Secretary of the Treasury may at any time 
sell any of the notes or other obligations acquired by him under this 
subsection. All redemptions, purchases, and sales by the Secretary of 
the Treasury of such notes or other obligations shall be treated as 
public debt transactions of the United States. Sums borrowed under 
this subsection shall be deposited in the fund and redemption of such 
notes and obligations shall be made by the Secretary from the fund. 
"(f)(1) The cumulative total of the principal of the loans outstand- 
Limitations,, 
ing at any time with respect to which guarantees have been issued 
under this section may not exceed such limitations as may be specified 
in appropriation Acts. 
"(2) In any fiscal year no loan guarantee may be made under sub-
section (a) and no agreement to make interest subsidy payments may 
be entered into under subsection (b) if the making of such guarantee 
or the entering into of such agreement would cause the cumulative 
total of— 
"(A) the principal of the loans guaranteed under subsection 
(a) in such fiscal year, and 
"(B) the principal of the loans for which no guarantee has been 
made under subsection (a) and with respect to which an agree-
ment to make interest subsidy payments is entered into under 
subsection (b) in such fiscal year, 
to exceed the amount of grant funds obligated under this part in such 
fiscal year for construction grants; except that this paragraph shall 
not apply if the amount of grant funds so obligated in such fiscal year 
equals the sums appropriated for such fiscal year under section 801. 
^"'^' P' '^^^' 
"(g) The Secretary, with the consent of the Secretary of Housing 
Administrative 
and Urban Development, may obtain from the Department of Hous- ^^^'^'^"''^• 
mg and Urban Development such assistance with respect to the admin-
istration of this section as will promote efficiency and economy 
thereof." 
(d) INTERIM FACILITIES.— 
(1) Section 843(i) (42 U.S.C. 298b(i)) is amended by adding 
's stat. 918. 
75-432 O - 72 - 32 
468 
PUBLIC LAW 92-158-NOV. 18, 1971 
[85 STAT. 
at the end the following: "For purposes of this paragraph, the 
term 'buildings' includes interim facilities.", 
tie"^"'"'" ^^""" 
^^) Section 843 (42 U.S.C. 298b) is amended by adding at the 
7
8
* Stat. 918. 
©ud thereof the following new paragraph: 
"(j) The term 'interim facilities' means teaching facilities 
designed to provide teaching space on a short-term (less than ten 
years) basis while facilities of a more permanent nature are being 
planned and constructed." 
(3) Sections 802(b) (2) (A) and 804 (42 U.S.C. 296a (b) (2) 
^
^
7
^
8 Stat. 909, 
(A), 296c) are each amended by inserting "(or in the case of 
interim facilities, within such shorter period as the Secretary shall 
by regulation prescribe)" immediately after "twenty years". 
(e) TECHNICAL AMENDMENTS.— 
(1) Section 802(a) (42 U.S.C. 296a(a)) is amended to read as 
follows: 
" (a) The Secretary may from time to time set dates (not earlier 
than in the fiscal year preceding the year for which a grant is 
sought) by which applications for grants under this part for any 
fiscal year must be filed." 
(2) Section 802 (b) (3) (B) (42 U.S.C. 296a (b)) is amended 
to read as follows: "(B) in the case of an application for a grant 
to assist in the replacement or rehabilitation of existing facilities, 
such application is for aid in construction which will replace or 
rehabilitate facilities of, or used by, an existing school of nursing, 
which facilities either are so obsolete as to require the school to 
curtail substantially either its enrollment or the quality of the 
training provided or are required to meet an increase in student 
enrollment;". 
(f) 
ENROLLMENT INCREASE; WAIVER.— 
(1) Effective in the case of grants made after the date of enact-
ment of this Act, section 802 (b) (2) (D) (42 U.S.C. 296a (b) 
(2) (D)) is amended by inserting immediately before the semi-
colon at the end thereof the following: ", and the requirements of 
this clause (D) shall be in addition to the requirements of section 
Post, p. 470. 
8Qg (g) Qf ^j^jg ^p^^ where applicable". 
(2) Section 802 (b) (42 U.S.C._296a (b)) is amended by add-
ing at the end thereof the following new sentence: "If a school 
of nursing applies for a grant in a fiscal year for a construction 
project to expand its training capacity and if under paragraph 
(2) of subsection (e) of section 806 such school is not required 
to meet in such fiscal year the enrollment increase prescribed by 
such subsection because of limitations of physical facilities, the 
Secretary, after consultation with the National Advisory Council 
on Nurse Training, may waive (in whole or in part) the enroll-
ment increase prescribed by paragraph (2) (D) of this subsection 
if the application for such construction project contains or is sup-
ported by reasonable assurances satisfactory to the Secretary that 
the number of first-year students enrolled at such school during 
the first full school year after the completion of such project and 
for each of the next nine school years thereafter will be not less 
than the number of first-year students that such school would be 
required to enroll under section 806 (e) (without regard to para-
graph (2) thereof) for a grant under section 806 (a)." 
85 STAT. ] 
PUBLIC LAW 92-158-NOV. 18, 1971 
469 
SPECIAL PROJECT GRANTS AND CONTRACTS; FINANCIAL DISTRESS 
GRANTS 
SEC. 3. (a) AUTHORIZATION LEVEL.—Section 808 (42 U.S.C. 296g) is 
82 stat. 783. 
amended to read as follows: 
"SEC. 808. For payments under grants and contracts under section 
805(a) there are authorized to be appropriated $20,000,000 for the ^"ira. 
fiscal year ending June 30, 1972; $28,000,000 for the fiscal year ending 
June 30,1973; and $35,000,000 for the fiscal year ending June 30,1974. 
There are authorized to be appropriated $15,000,000 for the fiscal year 
ending June 30, 1972, $10,000,000 for the fiscal year ending June 30, 
1973, and $5,000,000 for the fiscal year ending June 30, 1974, to make 
grants under section 805 (b), and, to the extent that sums appropriated 
under this sentence are not used for such grants, for grants under 
section 805(a)." 
(b) ASSISTANCE AUTHORIZED.—Effective with respect to appropria-
tions made under section 808 of the Public Health Service Act (42 
U.S.C. 296g) for fiscal years beginning after June 30, 1971, section 
805 (42 U.S.C. 296d) is amended to read as follows: 
8 2 stat. 781. 
"SPECIAL PROJECT GRANTS AND CONTRACTS; FINANCIAL DISTRESS 
GRANTS 
"SEC. 805. (a) From appropriations under section 808 the Secretary 
may make grants to public and other non-profit private schools of 
nursing and other public or non-profit private agencies, organizations 
and institutions, and enter into contracts with any public or private 
agencies, organizations, or institutions, to meet the costs of special 
projects to— 
"(1) assist in— 
"(A) mergers between hospital training programs or 
between hospital training programs and academic institu-
tions, or 
"(B) other cooperative arrangements among hospitals and 
academic institutions, 
leading to the establishment of nurse training programs; 
" (2) develop training programs, and train, for new roles, types, 
or levels of nursing personnel, including programs for the train-
ing of pediatric nurse practitioners or other types of nurse 
practitioners; 
" (3) develop programs for cooperative interdisciplinary train-
ing among schools of nursing and schools of allied health, medi-
cine, dentistry, osteopathy, optometry, podiatry, pharmacy, public 
health, or veterinary medicine, including training for the use of 
the team approach to the delivery of health services; 
" (4) assist in increasing the supply, or improving the distribu-
tion, of adequately trained nursing personnel or to promote the 
full utilization of nursing skills; 
"(5) effect significant improvements in the curriculums of 
schools of nursing; 
"(6) research, develop, or demonstrate advances in the various 
fields related to education in nursing; 
" (7) plan, develop, or establish new programs or modifications 
of existing programs of nursing education; 
"(8) increase educational opportunities for disadvantaged 
students; 
" (9) provide continuing education for nurses; 
"(10) provide appropriate retraining opportunities for nurses 
who (after periods of professional inactivity) desire again actively 
to engage in the nursing profession; 
470 
PUBLIC LAW 92-158-NOV. 18, 1971 
[85 STAT. 
•'(11) otherwise strengthen, improve or expand programs to 
train nursing jiersonnel, or 
"(12) help to increase the supply or improve the distribution 
by geographic area or by specialty group of adequately trained 
nursing personnel needed to meet the health needs of the Nation, 
including the need to increase the availability of personal health 
services and the need to promote preventive health care. 
Contracts may be entered into under this subsection Avithout regard to 
sections 3648 and 3709 of the Revised Statutes (31 U.S.C. 529; 41 
U.S.C.5). 
"(b) The Secretary may also make grants from appropriations 
Ante, p. 469. 
under section 808 to assist public or nonprofit private schools of nurs-
ing which ai'e in serious financial straits to meet operational costs 
required to maintain quality educational programs or which have 
special need for financial assistance to meet accreditation require-
ments. Any such grant may be made upon such terms and conditions 
as the Secretary determines to be reasonable and necessary, including 
requirements that the school agree (1) to disclose any financial infor-
mation or data deemed by the Secretary to be necessary to determine 
the sources or causes of that school's financial distress, (2) to conduct 
a comprehensive cost analysis study in cooperation with the Secretary, 
and (3) to carry out appropriate operational and financial reforms on 
the basis of information obtained in the course of the comprehensive 
cost analysis study or on the basis of other relevant information. 
"(c) An application for a grant under subsection (b) must contain 
or be supported by assurances satisfactory to the Secretary that the 
applicant will expend in carrying out its functions as a school of nurs-
ing, during the fiscal year for which such grant is sought, an amount 
of funds (other than funds for construction as determined by the Sec-
retary) from non-Federal sources which is at least as great as the 
average amount of funds expended by such applicant for such purpose 
(excluding expenditures of a nonrecurring nature) in the three fiscal 
years immediately preceding the fiscal year for which such grant is 
sought. The Secretary may, after consultation Avith the National Advi-
sory Council on Nurse Training, waive the requirement of the preced-
ing sentence with respect to any school if he determines that the 
application of such requirement to such school would be inconsistent 
with the purposes of subsection (b). 
caT^facimus'^'" 
"(^) "^^^ Secretary may, with the advice of the National Advisory 
utilization. ' 
Council on Nurse Training, provide assistance (including assistance 
under this section which may be provided without regard to section 
42 u*sc 2
^
9
6
^
/ 
^^"^^ ^^ ^^® heads of other departments and agencies of the Govern-
ment to encourage and assist in the utilization of medical facilities 
under their jurisdiction for nurse training programs." 
INSTITUTIONAL SUPPORT 
SEC. 4. (a) CAPITATION GRANTS.—Effective with respect to appro-
priations for fiscal years beginning after June 30, 1971, section 806 
8 2 Stat. 781. 
(42 U.S.C. 296e) is amended to read as follows: 
"CAPITATION GRANTS 
"SEC. 806. (a) GRANT COMPUTATION.—The Secretary shall make 
annual grants to schools of nursing for the support of the education 
programs of such schools. The amount of the annual grant to each 
such school with an approved application shall be computed as follows: 
" (1) Each such school shall receive— 
85 STAT. ] 
PUBLIC LAW 92-158-NOV. 18, 1971 
471 
" (A) $250 for each full-time student enrolled in such school 
in such year (other than a student who will graduate from 
such school in such year); 
"(B) $500 for each full-time student enrolled in such school 
who will graduate in such year; and 
"(C) $100 for each enrollment bonus student (as deter-
mined under subsection (d)) enrolled in such school in such 
year; and 
"(2) Each such school which has a training program for the 
training of nurse midwives, family health nurses, pediatric nurse 
practitioners, or similar nurse practitioners shall receive— 
"(A) $250 for each full-time student enrolled in such pro-
gram m such year (other than a student who will complete 
the training provided under such program in such year); 
and 
"(B) $900 for each full-time student enrolled in such pro-
gram who will complete the training provided under such 
program in such year. 
"(b) APPORTIONMENT or APPROPRIATIONS.—If the total of the grants 
to be made under subsection (a) for any fiscal year to schools with 
approved applications exceeds the amounts appropriated under subsec-
tion (i) for such grants, the amount of the grant for that fiscal year 
to each such school shall be an amount which bears the same ratio to 
the amount determined for the school for that fiscal year under sub-
section (a) as the total of the amounts appropriated under subsection 
(i) for that year bears to the amount required to make grants to each 
school in accordance with subsection (a). 
"(c) 
ENROLLMENT BONUS STUDENT DEFINED.—For purposes of 
subsection (a), a full-time student enrolled for any school year in a 
school of nursing shall be considered to be an enrollment bonus student 
if— 
"(1) he enrolled in such school as a first-year student for a 
school year beginning after June 30,1971; and 
" (2) the size of the class of first-year students which enrolled in 
such school for such school year met the applicable requirement of 
subsection (d) (1) (A) or (d) (2) (A), and the application of such 
school for a grant under this section for the fiscal year in which 
such school year began met the applicable requirement of sub-
section (d)(1)(B) or (d)(2)(B). 
Any student who is considered to be an enrollment bonus student for 
the school year for which he enrolled as a first-year student in a school 
shall be considered to be an enrollment bonus student for each school 
year thereafter for which he is enrolled in such school (other than as 
a student enrolled in a training program described in subsection 
(a)(2)). 
"(d) 
CLASS SIZE AND APPLICATION EEQUIREMENTS FOR GRANTS FOR 
BONUS ENROLLMENT STUDENTS.— 
"(1) School year 1971-1972.—If the school year for which a 
class enrolled as a class of first-year students in a school was the 
first school year beginning after June 30,1971— 
"(A) the number of students who enrolled in such class for 
such school year must exceed the number of first-year stu-
dents who enrolled in such school for the preceding school 
year by 5 per centum of such number or by five students, 
whichever is greater; and 
"(B) the application of such school for a grant under this 
section for the fiscal year ending June 30, 1972, contains or is 
supported by reasonable assurances that, for the first school 
year beginning after June 30, 1972 and for each school year 
472 
PUBLIC LAW 92-158-NOV. 18, 1971 
[85 STAT. 
thereafter, the number of students enrolled in such school as 
a class of first-year students will not be less than a number 
equal to the sum of— 
"(i) the minimum enrollment of first-year students 
required under subparagraph ( A ) ; and 
"(ii) 5 per centum of the average of the 
first-year 
enrollment of full time students in such school for the 
two school years having the highest such enrollment dur-
ing the five school years during the period of July 1, 
1966, through June 30, 1971, or ten students, whichever 
is greater. 
"(2) School years after school year 1971-1972.—If the school 
year for which a class enrolled as a class of first-year students in 
a school was any school year beginning after June 30, 1972— 
"(A) the number of students who enrolled in such class 
for such school year— 
"(i) if such school has not previously received a grant 
for bonus enrollment students, must be not less than the 
sum of (I) the minimum number of first-year students 
which such school is required pursuant to subsection (e) 
(or would be required pursuant to subsection (e) except 
for paragraph (2) thereof) to enroll for such school year, 
and (II) 5 per centum of that number or 5 students, 
whichever is greater; or 
" (ii) if such school has previously qualified for a bonus 
enrollment grant under this section, must be not less than 
the sum of (I) the minimum number of students which 
such school was required, pursuant to paragraph (1) 
(B) or (2)(B) (as the case may be), to assure the 
Secretary would be enrolled for such school year, and 
(II) 5 per centum of that number or 5 students, which-
ever is greater; and 
"(B) the application of such school for a grant under this 
section for the fiscal year in which such school year begins 
contains or is supported by reasonable assurances that, for 
the first school year beginning after the close of such fiscal 
year and for each fiscal year thereafter, the number of stu-
dents enrolled in such school as a class of first year students 
will not be less than the minimum number of students such 
school was required under subparagraph (A) to enroll as 
first year students. 
"(e) 
MAINTENANCE 
or 
EFFORT 
AND 
ENROLLMENT 
INCREASE 
REQUIREMENTS.— 
"(1) The Secretary shall not make a grant under this section to 
any school in a fiscal year beginning after June 30,1971, unless the 
application for such grant contains or is supported by reasonable 
assurances satisfactory to the Secretary— 
" (A) that for the first school year beginning after the close 
of the fiscal year in which such grant is made and for each 
school year thereafter during which such a grant is made the 
first-year enrollment of full-time students in such school will 
exceed the average of the first-year enrollment of such stu-
dents in such school for the two school years having the high-
est such enrollment during the five school years during the 
period July 1, 1966, through June 30, 1971, by at least 5 per 
centum of such average first-year enrollment, or by ten stu-
dents, whichever is greater; and 
"(B) that the applicant will expend in carrying out its 
function as a school of nursing, during the fiscal year for 
78 Stat. 909. 
42 u s e 296a„ 
85 STAT. ] 
PUBLIC LAW 92-158-NOV. 18, 1971 
473 
which such grant is sought, an amount of funds (other than 
funds for construction as determined by the Secretary) from 
non-Federal sources which is at least as great as the average 
amount of funds expended by such applicant for such purpose 
(excluding expenditures of a nonrecurring nature) in the 3 
fiscal years immediately preceding the fiscal year for which 
such grant is sought. 
The requirements of subparagraph (A) shall be in addition to 
the requirements of section 802(b)(2)(D) of this Act, where 
applicable. 
"(2) The Secretary is authorized to waive (in whole or in part) 
the provisions of paragraph (1) (A) if he determines, after con-
sultation with the National Advisory Council on Nurse Training, 
that the required increase in first-year enrollnient of full-time 
students in a school cannot, because of limitations of physical 
facilities available to the school for training or because of other 
relevant factors, be accomplished without lowering the quality of 
training provided therein. 
"(f) 
PLAN REQUIREMENT.— 
"(1) In the case of a school which has not received a grant 
under subsection (a) in a fiscal year beginning after June 30,1971, 
an application by such school for such a grant for a fiscal year 
beginning after that date may not be approved by the Secretary 
unless the application contains or is accompanied by a plan to 
carry out, or establish and carry out, during the two-school year 
period commencing not later than the first day of the fiscal year 
next following the fiscal year in which the grant is made, specific 
projects in at least three of the following categories of projects: 
"(A) Projects to assist in— 
"(i) mergers between hospital training programs or 
between hospital training programs and academic insti-
tutions, or 
" (ii) affiliation agreements with hospitals or academic 
institutions; 
leading to the establishment of nurse training programs. 
"(B) Projects to train for new roles, types, or levels of 
nursing personnel, including programs for the training of 
pediatric nurse practitioners or other types of nurse practi-
tioners, in cooperation with appropriate academic institutions 
or hospitals. 
"(C) Projects to establish cooperative intradisciplinary 
training among schools of nursing with a view toward estab-
lishment of interchangeable curriculum or shared use of 
resources. 
"(D) Projects to establish cooperative interdisciplinary 
training between schools of nursing and schools of allied 
health, medicine, dentistry, osteopathy, optometry, podiatry, 
pharmacy, public health, or veterinary medicine, including 
training for the use of the team approach to the delivery of 
health services. 
"(E) Projects to assist in increasing the supply of ade-
{^uately trained nursing personnel or to promote the full uti-
lization of nursing skills. 
"(F) Projects to effect significant improvements in the 
curricula of schools of nursing (including projects with 
a view toward the assumption of greater patient care 
responsibilities). 
474 
PUBLIC LAW 92-158-NOV. 18, 1971 
[85 STAT. 
On-site inspec-
tions. 
Reports to con-
gressional com-
mittees. 
82 Stat, 785, 
42 u s e 298c. 
"Full-time 
students," 
Ante, 
p, 465, 
"(G) Projects to provide in-service or other training and 
education to upgrade the skills of licensed vocational or 
licensed practical nurses, nursing assistants, and aides, and 
other paraprofessional nursing personnel. 
"(H) Projects to increase admissions to, and enrollment 
and retention in, such schools of qualified individuals who, 
due to socioeconomic factors, are financially or educationally 
disadvantaged. 
"(2) The Secretary may make on-site inspections of any school, 
or require the supplying of information or data from any school, 
receiving a grant under subsection (a) to determine the extent 
to which such school is carrying out the specific projects required 
to be included in the plan submitted by such school (pursuant to 
paragraph (1)) in connection with its application for such grant. 
"(3) The Secretary shall submit to the Committee on Labor 
and Public Welfare of the Senate and the Committee on Inter-
state and Foreign Commerce of the House of Representatives 
two reports containing full and complete information as to the 
extent to which schools receiving grants under subsection (a) are 
carrying out the specific projects included in plans submitted by 
them pursuant to paragraph (1). The first such report shall be 
submitted not later than January 1, 1973, and the second such 
report shall be submitted not later than September 1, 1974. 
"(g) 
ENROLLMENT AND GRADUATION DETERMINATIONS.— 
"(1) For purposes of this part and part D, regulations of the 
Secretary shall include provisions relating to determination of 
the number of students enrolled in a school, or in a particular 
year-class in a school, or the number of graduates, as the case 
may be, on the basis of estimates or on the basis of the number 
of students who were enrolled in a school, or in a particular year-
class in a school, or were graduates, in an earlier year, as the case 
may be, or on such basis as he deems appropriate for making such 
determination, and shall include methods of making such deter-
mination when a school or a year-class was not in existence in <an 
earlier year at a school. 
"(2) For purposes of this part and part D, the term 'full-time 
students' (whether such term is used by itself or in connection 
with a particular year-class) means students pursuing a full-time 
course of study in an accredited program in a school of nursing. 
"(h) APPLICATIONS FOR NEW SCHOOLS.—In the case of a new school 
of nursing which applies for a grant under this section in the fiscal 
year preceding the fiscal year in which it will admit its first class, the 
enrollment for purposes of subsection (a) shall be the number of full-
time students which the Secretary determines, on the basis of assur-
ances provided by the school, will be enrolled in the school, in the fiscal 
year after the fiscal year in which the grant is made, 
"(i) 
AUTHORIZATION or APPROPRIATIONS.— 
"(1) There are authorized to be appropriated $78,000,000 for 
the fiscal year ending June 30, 1972, $82,000,000 for the fiscal year 
ending June 30, 1973, and $88,000,000 for the fiscal year ending 
June 30,1974, for grants under this section. 
"(2) No funds appropriated under any provision of this Act 
(other than this subsection) may be used to make grants under 
this section." 
(b) START-UP GRANTS.—Part A of title VIII is amended by adding 
after the section 809 of such title (added by section 2(c) of this Act) 
the following new section: 
85 STAT. ] 
PUBLIC LAW 92-158-NOV. 18, 1971 
475 
"START-UP GRANTS FOR NEW NURSE TRAINING PROGRAMS 
"SEC. 810. (a) The Secretary may make grants to any public or non-
profit private entity to assist in meeting the costs of planning, devel-
oping, or initiating new programs of nurse training. In considering 
applications for grants under this section, the Secretary shall take 
into account— 
"(1) the number of students proposed to be enrolled in such 
program, and 
"(2) the other resources available to such program. 
" (b) The Secretary shall give special consideration to each applica-
tion for grant assistance under this section for a new program of nurse 
training which contains or is reasonably supported by assurances that, 
because of the use that the program will make of existing facilities 
(including Federal medical facilities), it will be able to accelerate the 
date on which it will begin its teaching program. 
"(c) The amount of any grant under this section shall be determined 
by the Secretary, but in no event may any grant exceed $100,000 for 
any fiscal year. Payments under such grants may be made in advance 
or by way of reimbursement, and at such intervals and on such condi-
tions, as the Secretary finds necessary. 
"(d) There are authorized to be appropriated to carry out this sec- 
Appropriation. 
tion not to exceed $4,000,000 for the fiscal year endinfr Juno 80, 1972, 
$8,000,000 for the fiscal year ending June 30,1973, and $12,000,000 for 
the fiscal year ending June 30, 1974. Sums appropriated under this 
subsection shall remain available until expended." 
(c) TECHNICAL AMENDMENTS.— 
(1) Sections 807(a) and 807(c) (42 U.S.C. 296f (a), 296f(c)) 
82 stat. 782. 
are each amended by striking out "805 or 806" and inserting in 
lieu thereof "805, 806, or 810". 
(2) Section 807(c) (1) is amended by inserting "or 810" imme-
diately after "805". 
(3) Section 807(c) is amended by striking out "this part" each 
place it appears in paragraphs (3) and (4) and inserting in lieu 
thereof "those sections". 
(4) Section 807(c) is further amended by striking out para-
graph (2) and by redesignating paragraphs (3) and (4) as para-
graphs (2) and (3), respectively. 
TRAINEESHIPS FOR ADVANCED TRAINING OF PROFESSIONAL NURSES 
SEC. 5. Authorization of Appropriations for Advanced Trainee-
ships.—Section 821(a) (42 U.S.C. 297(a)) is amended (1) by striking 
78 stat. 9i3: 
out "and" after "1970,", and (2) by inserting after "1971," the follow- °' ""^ " ' 
ing: "$20,000,000 for the fiscal year ending June 30, 1972, $22,000,000 
for the fiscal year ending June 30, 1973, and $24,000,000 for the fiscal 
year ending June 30,1974,". 
LOANS 
SE(^ 6. (a) 
LOAN CEILINGS. 
(1) Effective with respect to academic years (or their equivalent 
as determined under regulations of the Secretary of Health, 
Education, and Welfare under section 823 of the Public Health 
Service Act (42 U.S.C. 297b) beginning after June 30, 1971, 
subsection (a) of such section is amended by striking out "$1,500" 
and inserting in lieu thereof "$2,500". 
(2) Section 823 (a) (42 U.S.C. 297b (a)) is amended by strik-
ing out "$6,000" and inserting in lieu thereof "$10,000". 
82 Stat. 783. 
476 
PUBLIC LAW 92-158-NOV. 18, 1971 
[85 STAT. 
(b) 
LoAX REPAYMENT AXD FORGIVEXESS. 
sJltlTjsVf'' 
(1) (^) Section 8:28(b) (8) (42 I^S.C. 297b(c)) is amended to read 
as follows: 
"(3) an amount up to 85 per centum of any such loan (plus 
interest thereon) shall be canceled for full-time employment as a 
professional nurse (including teaching in any of the fields of 
nurse training and service as an administrator, supervisor, or 
consultant in any of the fields of nursing) in any public or non-
profit private agency, institution, oi- organization 
(including 
neighborhood health centers), at the late of 15 per centum of the 
amount of such loan (plus intei'est) unpaid on the first day of 
such service for each of the first, second, and third complete year 
of such service, and 20 per centum of such amount (plus interest) 
for each complete fourth and fifth year of such service;". 
Shortage area, 
/j^) Sectiou 823 Is amended by adding at the end thereof the 
service agree- 
/• H 
• 
i 
i-
tnent. 
followmg uew subscctiou: 
"(h) (1) In the case of any individual— 
"(A) who has received a baccalaureate or associate degree in 
nursing (or an equivalent degree), a diploma in nursing, or a 
graduate degree in nui'sing; 
"(B) who obtained (A) one or more loans from a loan fund 
established under this part, or (B) any other educational loan for 
nurse training costs; and 
"(C) who enters into an agreement with the Secretary to serve 
as a nurse for a period of at least two years in an area in a State 
determined by the Secretary, after consultation with the appro-
priate State health authority (as determined by the Secretary by 
regulations), to have a shortage of and need for nurses; 
the Secretary shall make payments in accordance with paragraph (2), 
for and on behalf of that individual, on the principal of and interest on 
any loan of that individual described in subparagraph (B) of this 
paragraph which is outstanding on the date the individual begins the 
service specified in the agreement described in subparagraph (C) of 
this paragraph. 
"(2) The payments described in paragraph (1) shall be made by 
the Secretary as follows: 
"(A) Upon completion by the individual for whom the pay-
ments are to be made of the first year of the service specified in the 
agreement entered into with the Secretary under paragraph (1), 
the Secretary shall pay 30 per centum of the principal of, and the 
interest on each loan of such individual described in paragraph 
(1) (B) which is outstanding on the date he began such practice. 
"(B) Upon completion by that individual of the second year of 
such service, the Secretary shall pay another 30 per centum of the 
principal of, and the interest on each such loan. 
"(C) Upon completion by that individual of a third year of 
such service, the Secretary shall pay another 25 per centum of the 
principal of, and the interest on each such loan. 
"(3) Notwithstanding the requirement of completion of practice 
specified in paragraph (2), the Secretary shall, on or before the due 
date thereof, pay any loan or loan installment which may fall due 
within the period of service for which the borrower may receive pay-
ments under this subsection, upon the declaration of such borrower, 
at such times and in such manner as the Secretary may prescribe (and 
supported by such other evidence as the Secretary may reasonably 
require), that the borrower is then engaged as described by paragraph 
(1) or paragraph (2) (C), and that the borrower will continue to be 
so engaged for the period required (in the absence of this paragraph) 
to entitle the borrower to have made the payments provided by this 
85 STAT.] 
PUBLIC LAW 92-1 5 8 - N O V . 18, 1971 
477 
subsection for such period; except that not more than 85 per centum 
of the principal of any such loan shall be paid pursuant to this 
paragraph. 
"(4) A borrower who fails to fulfill an agreement with the Secre- 
Reimbursement. 
tary entered into under paragraph (1) or assurances provided pursu-
ant to paragraph (2) (C) shall be liable to reimburse the Secretary 
for any payments made pursuant to paragraph (2) (A) or paragraph 
(3) in consideration of such agreement. 
(i) Notwithstanding the amendment made by section 6 (b) of 
the Nurse Training Act of 1971 to this section— 
^"'^' P* '•^S. 
"(A) any person who obtained one or more loans from a 
loan fund established under this part, w^ho before the date of 
the enactment of the Nurse Training Act of 1971 became 
eligible for cancellation of all or part of such loans (includ-
ing accrued interest) under this section (as in effect on the 
day before such date), and who on such date was not engaged 
in a service for which loan cancellation was authorized under 
this section (as so in effect), may at any time elect to receive 
such cancellation in accordance with this subsection (as so 
in effect) ; and 
"(B) in the case of any person who obtained one or more 
loans from a loan fund established under this part and who 
on such date was engaged in a service for which cancellation 
of all or part of such loans (including accrued interest) was 
authorized under this section (as so in effect), this section (as 
so in effect) shall continue to apply to such person for pur-
poses of providing such loan cancellation until he terminates 
such service. 
"Nothing in this subsection shall be construed to prevent any person 
from entering into an agreement for loan cancellation under subsection 
(h) (as amended by section 6 (b) (2) of the Nurse Training Act of 
1971)." 
(2) Part r> of title VIII of such Act is amended by adding after ^^^°f" ^°'^'''^' 
section 829 thereof the following new section: 
82 stat. 78 s. 
"SEC. 830. (a) Upon application by a person who received, and is 
'^^ "^^ ^'^'^^' 
under an obligation to repay, any loan made to such person as a nurs-
ing student, the Secretary may undertake to repay (without liability 
to the applicant) all or any part of such loan, and any interest or por-
tion thereof outstanding thereon, upon his determination, pursuant to 
regulations establishing criteria therefor, that the applicant— 
"(1) failed to complete the nursing studies with respect to 
which such loan was made; 
" (2) is in exceptionally needy circumstances; 
"(3) is from a low-income or disadvantaged family as those 
terms may be defined by such regulations; and 
"(4) has not resumed, or cannot reasonably be expected to 
resume, such nursing studies within two years following the date 
upon which the applicant terminated the studies with respect to 
which such loan was made." 
(c) 
AUTHORIZATION LEVEL.—Section 824 (42 U.S.C. 297c) is ^Jl^ll^^;^^^^' 
amended (1) by striking out "and $21,000,000" and all that follows up 
to, and including, the word "education", and inserting in lieu of the 
matter stricken the following: "$21,000,000 for the fiscal year ending 
June 30, 1971, $25,000,000 for the fiscal year ending June 30, 1972, 
$30,000,000 for the fiscal year ending June 30, 1973, and $35,000,000 
for the fiscal year ending June 30, 1974, and such sums for the fiscal 
year ending June 30, 1975, and each of the two succeeding fiscal years 
as may be necessary to enable students who have received a loan for 
any academic year ending before July 1,1974, to continue or complete 
their education". 
82 Stat. 784. 
478 
PUBLIC LAW 92-158-NOV. 18, 1971 
[85 STAT. 
(d) 
TECHNICAL AMENDMENTS.— 
Ante,p, 145. 
(]^^ SectioH 826 (42 U.S.C. 297e) is amended by striking out 
"1975" each place it occurs and inserting in lieu thereof "1977". 
(2) The first sentence of section 827(a) (1) (42 U.S.C. 297f) is 
amended by striking out "next four fiscal years" and inserting in 
lieu thereof "next six fiscal years". 
82 Stat. 783. 
(3) Sectiou 822(b) (4) (42 U.S.C. 297a(b) (4)) is amended by 
striking out "1971" and inserting in lieu thereof "1974". 
(e) EXPANSION or ELIGIBILITY FOR LOANS.—Sections 822(b) (4) and 
823(b)(1) and the part of section 823(b)(2) preceding clause (A) 
82'ltatl'784.''' 
thereof (42 U.S.C. 297a(b)(4), 297b(b)(l), 297b(b)(2)) are each 
amended by striking out "full-time course of study" and inserting in 
lieu thereof "full-time or half-time course of study". 
SCHOLARSHIP GRANTS 
SEC. 7. Effective with respect to scholarship grants made under sub-
section (a) of section 860 of the Public Health Service Act (42 U.S.C. 
8 2 Stat. 786. 
298c) foT fiscal years beginning after June 30,1971— 
(1) subsection (b) of such section is amended to read as follows: 
"(b) The amount of the grant under subsection (a) for the 
fiscal year ending June 30, 1972, and for each of the next two 
fiscal years to each such school shall be equal to $3,000 multi-
plied by one-tenth of the number of full-time students of such 
school. For the fiscal year ending June 30, 1975, and for each 
of the two succeeding fiscal years, the grant under subsection 
(a) shall be such amount as may be necessary to enable such 
school to continue making payments under scholarship awards 
to students who initially received such awards out of grants 
made to the school for fiscal years ending before July 1, 
1974."; 
Ante, p. 145. 
^2) subsectiou (c) (1) of such section is amended (A) by strik-
ing out "1970, and the next two fiscal years" in clause (A) and 
inserting in lieu thereof "1972, and the next two fiscal years", (B) 
by striking out "1972" in clause (B) and inserting in lieu thereof 
"1974", and (C) by striking out "1973, and each of the three" in 
such clause and inserting in lieu thereof "1975, and each of the 
two"; 
(3) subsection (c) (2) of such section is further amended by 
striking out "$1,500" and inserting in lieu thereof "$2,000"; and 
(4) subsection (c) (1) of such section is amended by inserting 
"or half-time" immediately after "full-time" each place it occurs. 
G R A N T S 
A N D CONTRACTS TO ENCOURAGE FULL UTILIZATION OF 
EDUCATIONAL TALENT FOR THE NURSING PROFESSION 
4
°
2 vie 298C-7. 
^^^^ ^•. ^ection 868 of the Public Health Service Act (together with 
the heading thereto) is amended to read as follows : 
" G R A N T S 
AND 
CONTRACTS 
TO 
ENCOURAGE 
FULL 
UTILIZATION 
OF 
EDUCATIONAL TALENT FOR T H E NURSING PROFESSION 
"SEC. 868. (a) To assist in meeting the need for additional pro-
fessional personnel in the nursing professions, the Secretary is 
authorized to make grants to public or nonprofit health or educational 
entities or enter into contracts with such entities not to exceed 
$100,000 per year per contract (without regard to section 3709 of the 
Revised Statutes (41 U.S.C. (5)) for the purpose of— 
85 STAT. ] 
PUBLIC LAW 92-158-NOV. 18, 1971 
479 
"(1) identifying individuals with a potential for education or 
training in the nursing profession (including veterans of the 
Armed Forces of the United States with training or experience 
in the health field, and individuals who due to socioeconomic fac-
tors are financially or otherwise disadvantaged) and encouraging 
and assisting them (A) to enroll in a school of nursing which is 
accredited as defined in section 843(f) ; or (B) if they are not siltlT^VBsVaj 
qualified to enroll in such a school to undertake such postsecondary 
42 use 298b. 
education or training as may be required to qualify them to enroll 
in such a school; 
"(2) publicizing especially to licensed vocational nurses exist-
ing sources of financial aid available to persons enrolled in any 
such school or who are undertaking training necessary to qualify 
them to enroll in any such school; or 
"(3) establishing such programs as the Secretary determines 
will enhance and facilitate the enrollment, pursuit, and com-
pletion of study by individuals referred to in clause (1) in such 
schools. 
"(b) For the purposes of carrying out the provisions of this section. 
Appropriation. 
there is authorized to be appropriated $3,500,000 for the fiscal year 
ending June 30, 1972; $5,000,000 for the fiscal year ending June 30, 
11)73; and $6,500,000 for the fiscal year ending June 30, 1974." 
ADVISORY COUNCIL 
SEC. 9. Section 841 (a) (1) (42 U.S.C. 298(a) (1)) is amended-
(1) by striking out "sixteen members" in the first senten( 
1 
78 Stat. 917, 
sentence and 
inserting in lieu thereof "nineteen members": 
(2) by striking out "Four" in the second sentence and inserting 
in lieu thereof "Three of the appointed members shall be selected 
from full-time students enrolled in schools of nursing, four"; and 
(3) by adding at the end thereof the following: "The student-
members of the Council shall be appointed for terms of one year 
and shall be eligible for reappointment to the Council." 
ADVANCE FUNDING 
SEC. 10. Part C of title VIII of the Public Health Service Act is 
amended by adding after section 843 the following new section: 
" A D V A N C E FUNDING 
"SEC. 844. Any appropriation Act which appropriates funds for any 
fiscal year for grants, contracts, or other payments under this title 
may also appropriate for the next fiscal year the funds that are author-
ized to be appropriated for such payments for such next fiscal year; 
but no funds may be made available therefrom for obligation for such 
payments before the fiscal year for which such funds are authorized 
to be appropriated." 
PROHIBITION AGAINST DISCRIMINATION BY SCHOOLS ON T H E BASIS OF SEX 
SEC. 11. Part C of title VIII of the Public Health Service Act is 
^2 use 298. 
amended by adding at the end thereof the following new section: 
" P R O H I B I T I O N AGAINST DISCRIMINATION BY SCHOOLS ON T H E BASIS OF SEX 
"SEC. 845, The Secretary may not make a grant, loan guarantee, or 
interest subsidy payment under this title to, or for the benefit of, any 
school of nursing unless the application for the grant, loan guarantee, 
or interest subsidy payment contains assurances satisfactory to the 
480 
PUBLIC LAW 92-159-NOV. 18, 1971 
[85 STAT. 
Secretary that the school will not discriminate on the basis of sex in 
the admission of individuals to its training programs. The Secretary 
may not enter into a contract under this title with any school unless the 
school furnishes assurances satisfactory to the Secretary that it will 
not discriminate on the basis of sex in the admission of individuals to 
its training programs." 
REPORT 
SEC. 12. The Secretary shall prepare and submit to the Congress, 
prior to June 30,1974, a final report on the administration of title V I I I 
Ante, p. 465. 
^f f]^^^ Public Health Service Act which shall include an estimate of 
the increase in the number of persons entering the nursing profession 
effected under such title prior to the enactment of this Act; an estimate 
of such increase effected in consequence of the enactment of this Act ; 
an estimate of the number of nurses in relation to the need of the public 
therefor; and an appraisal of title VIII, as amended by this Act, to 
meet long-term national needs for nurses. The Secretary shall submit 
to the Congress a first interim report prior to June 30, 1973, and a 
second interim report prior to January 31, 1974, describing his pre-
liminary findings in the preparation of his final report. 
42 u s e 296-298. 
78 Stat. 917. 
TECHNICAL 
AMENDMENTS 
SEC. 13. Parts A, B, and C (other than section 841 (a) thereof) of 
title VIII are each amended by striking out "Surgeon General" each 
place it appears and inserting in lieu thereof "Secretary". Section 803 
(b) (42 U.S.C. 296b (b)) is amended by striking out "Surgeon Gen-
eral's" and inserting in lieu thereof "Secretary's". Section 841 (a) 
(42 U.S.C. 298 (a)) is amended by striking out "Surgeon General" 
and inserting in lieu thereof "Secretary (or his delegate)". 
Approved November 18, 1971. 
November 18, 1971 
[H. R. 5060] 
Public Law 92-159 
AN ACT 
To amend the Fish and Wildlife Act of 1956 to provide a criminal penalty for 
shooting at certain birds, fish, and other animals from an aircraft. 
Airborne hunt-
ing. 
Prohibition, 
70 Stat. 1119. 
16 u s e 742a 
note. 
Penalty. 
Exception. 
Be it enacted hy the Senate and House of Representatives 
of the 
United States of America in Congress assembled^ That the Fish and 
Wildlife Act of 1956 is amended by adding at the end thereof the 
following new section: 
"SEC. 13. (a) Any person who— 
"(1) while airborne in an aircraft shoots or attempts to shoot 
for the purpose of capturing or killing any bird, fish, or other 
animal; or 
"(2) uses an aircraft to harass any bird, fish, or other animal; 
or 
"(3) knowingly participates in using an aircraft for any pur-
pose referred to in paragraph (1) or (2) ; 
shall be fined not more than $5,000 or imprisoned not more than one 
year, or both. 
"(b) (1) This section shall not apply to any person if such person 
is employed by, or is an authorized agent of or is operating under a