Nurse Reinvestment Act
PL 107-205 (H.R.3487), enacted 08/01/2002

PUBLIC LAW 107-205—AUG. 1, 2002 
116 STAT. 811 
Public Law 107-205 
107th Congress 
An Act 
To amend the Public Health Service Act with respect to health professions programs 
regarding the field of nursing. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the "Nurse Reinvestment Act". 
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 facultv loan program. 
Sec. 204. Reports by General Accounting Office. 
TITLE I—NURSE RECRUITMENT 
Aug. 1, 2002 
[H.R. 3487] 
Nurse 
Reinvestment 
Act 
42 u s e 201 note. 
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 'ambula-
tory surgical center' has the meaning applicable to such term 
under title XVIII of the Social Security Act. 
"(10) FEDERALLY QUALIFIED HEALTH CENTER.—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 hospital, a Federally qualified health 
center, a rural health clinic, a nursing home, a home health 
agency, 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 186 l(o) 
of the Social Security Act. 
116 STAT. 812 
PUBLIC LAW 107-205—AUG. 1, 2002 
"(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 section 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 Pubhc Health Service Act (42 U.S.C. 296 
et seq.) is amended by adding at the end the following: 
"PART H—PUBLIC SERVICE ANNOUNCEMENTS 
42 u s e 297w. 
"SEC. 851. PUBLIC SERVICE ANNOUNCEMENTS. 
"(a) IN GENERAL.—The Secretary shall develop and issue public 
service announcements that advertise and promote the nursing 
profession, highlight the advantages and rewards of nursing, and 
encourage individuals to enter the nursing profession. 
"(b) METHOD.—The public service announcements described in 
subsection (a) shall be broadcast through appropriate 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. 
42 u s e 297x. 
«SEC. 852. STATE AND LOCAL PUBLIC SERVICE ANNOUNCEMENTS. 
"(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, high-
light the advantages and rewards of nursing, and encourage individ-
uals from disadvantaged backgrounds to enter the nursing profes-
sion. 
"(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 information on billboards or on the 
Internet in a manner intended to reach as wide and diverse an 
audience as possible, in order to— 
"(1) advertise and promote the nursing profession; 
"(2) promote nursing education programs; 
"(3) inform the public of financial assistance regarding 
such education programs; 
"(4) highlight individuals in the community who are prac-
ticing nursing in order to recruit new nurses; or 
"(5) provide any other information to recruit individuals 
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 opportunities. 
"(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.". 
PUBLIC LAW 107-205—AUG. 1, 2002 
116 STAT. 813 
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— 
(1) in paragraph (3), by striking "in an Indian Health 
Service health center" and all that follovi^s to the semicolon 
and inserting "at a health care facility vi^ith a critical shortage 
of nurses"; and 
(2) by adding at the end the follov^ing: "After fiscal year 
2007, the Secretary may not, pursuant to any agreement 
entered into under this subsection, assign 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 REPAY-
MENT PROGRAM" and inserting "LOAN REPAYMENT AND SCHOLAR-
SHIP 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 redesig-
nated) from their current placements, by inserting subsection 
(f) after subsection (e), and by inserting subsection (g) after 
subsection (f) (as so inserted); and 
(4) by inserting after subsection (c) the following subsection: 
"(d) SCHOLARSHIP PROGRAM.— 
"(1) IN GENERAL.—The Secretary shall (for fiscal years 2003 Contracts. 
and 2004) and may (for fiscal years thereafter) carry out a 
program of entering into contracts with eligible individuals 
under which such individuals agree to serve as nurses for 
a period of not less than 2 years at a health care facility 
with a critical shortage of nurses, in consideration of the Fed-
eral Government agreeing to provide to the individuals scholar-
ships 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 facility 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 subparagraph (A) on 
a part-time basis if the individual has a written agreement 
that— 
"(i) is entered into by the facility and the individual 
and is approved by the Secretary; and 
"(ii) provides that the period of obligated service 
will be extended so that the aggregate 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 
116 STAT. 814 
PUBLIC LAW 107-205—AUG. 1, 2002 
with this section, apply to the program estabhshed 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 period and inserting "under 
subsection (a) or (d), the Secretary shall give preference to qualified 
applicants with the greatest financial need.". 
(d) REPORTS.—Subsection (h) of section 846 of the Public Health 
Service Act (42 U.S.C. 297n) (as redesignated by subsection (b)(2)) 
is amended to read as follows: 
Deadline. 
"(h) REPORTS.—Not later than 18 months after the date of 
enactment of the Nurse Reinvestment Act, and annually 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 repay-
ments 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; 
"(9) the demographics of the individuals participating in 
the scholarship and loan repayment programs; 
"(10) justification for the allocation of funds between the 
scholarship and loan repayment programs; and 
"(11) an evaluation of the overall costs and benefits of 
the programs.". 
(e) FUNDING.—Subsection (i) of section 846 of the Public Health 
Service Act (42 U.S.C. 297n) (as redesignated 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 appropriated 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)-"-
PUBLIC LAW 107-205—AUG. 1, 2002 
116 STAT. 815 
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, including dis-
tance 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 arrange-
ments in noninstitutional settings to demonstrate methods to 
improve access to primary health care in medically underserved 
communities; 
"(2) providing care for underserved populations and other 
high-risk groups such as the elderly, individuals with HIV/ 
AIDS, substance abusers, the homeless, and victims of domestic 
violence; 
"(3) providing managed care, quality improvement, and 
other skills needed to practice in existing and emerging orga-
nized 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 paragraph (1) or (2). 
"(1) GRANTS FOR CAREER LADDER PROGRAMS.—-The Sec-
retary may award grants to and enter into contracts with 
eligible entities for programs— 
"(A) to promote career advancement for nursing per-
sonnel in a variety of training settings, cross training or 
specialty training among diverse population groups, and 
the advancement of individuals including to become profes-
sional nurses, advanced education nurses, licensed practical 
nurses, certified nurse assistants, and home health aides; 
and 
"(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. 
"(2) ENHANCING PATIENT CARE DELIVERY SYSTEMS.— 
"(A) GRANTS.—The Secretary may award grants to 
eligible entities to improve the retention of nurses and 
enhance patient care that is directly related to nursing 
activities by enhancing collaboration and communication 
among nurses and other health care professionals, and 
99-1940-03-2 :QL3Part2 
116 STAT. 816 
PUBLIC LAW 107-205—AUG. 1, 2002 
by promoting nurse involvement in the organizational 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 previously 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 such award contingent on the 
recipient of such award having demonstrated to the Sec-
retary 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 appro-
priated 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). 
Deadline. 
"(f) REPORT.—^The Secretary shall submit to the Congress 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 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 
Pubhc 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 
Grants. 
"SEC. 855. COMPREHENSIVE GERIATRIC EDUCATION. 
42 use 298 
"(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 providing 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 geri-
atric care for the elderly; 
"(2) develop and disseminate curricula relating to the treat-
ment of the health problems of elderly individuals; 
"(3) train faculty members in geriatrics; or 
"(4) provide continuing education to individuals who pro-
vide geriatric care. 
PUBLIC LAW 107-205—AUG. 1, 2002 
116 STAT. 817 
"(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 facility. 
"(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),". 
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 section 846 the following: 
"NURSE 
FACULTY 
LOAN 
PROGRAM 
"SEC. 
846A. (a) 
ESTABLISHMENT.—^The 
Secretary, 
acting 42USC297n-i. 
through the Administrator of the Health Resources and Services 
Administration, may enter into an agreement with any school of 
nursing for the establishment and operation 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 sub-
section (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, contributed 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 subsection (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 necessary to pro-
tect 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 prescribed 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 
116 STAT. 818 
PUBLIC LAW 107-205—AUG. 1, 2002? 
(a) may not exceed $30,000, plus any amount determined by 
the Secretary on an annual basis to reflect inflation; 
"(3) an amount up to 85 percent of any such loan (plus 
interest thereon) shall be canceled by the school as follows: 
"(A) upon completion by the individual of each of the 
first, second, and third year of full-time employment, 
required by the loan agreement entered into under this 
subsection, as a faculty member in a school of nursing, 
the school shall cancel 20 percent of the principle of, and 
the interest on, the amount of such loan unpaid on the 
first day of such employment; and 
"(B) upon completion by the individual of the fourth 
year of full-time employment, required by the loan agree-
ment entered into under this subsection, as a faculty 
member in a school of nursing, the school shall cancel 
25 percent of the principle of, and the interest on, the 
amount of such loan unpaid on the first day of such employ-
ment; 
"(4) such a loan may be used to pay the cost of tuition, 
fees, books, laboratory expenses, and other reasonable education 
expenses; 
"(5) such a loan shall be repayable in equal or graduated 
periodic installments (with the right of the borrower to accel-
erate repajnnent) over the 10-year period that begins 9 months 
after the individual ceases to pursue a course of study at 
a school of nursing; and 
"(6) such a loan shall— 
"(A) beginning on the date that is 3 months after 
the individual ceases to pursue a course of study at a 
school of nursing, bear interest on the unpaid balance 
of the loan at the rate of 3 percent per annum; or 
"(B) subject to subsection (e), if the school of nursing 
determines that the individual will not complete such 
course of study or serve as a faculty member as required 
under the loan agreement under this subsection, bear 
interest on the unpaid balance of the loan at the prevailing 
market rate. 
"(d) PAYMENT OF PROPORTIONATE SHARE.—Where all or 
any 
part of a loan, or interest, is canceled under this section, the 
Secretary shall pay to the school an amount equal to the school's 
proportionate share of the canceled portion, as determined by the 
Secretary. 
"(e) REVIEW BY SECRETARY.—At the request of the individual 
involved, the Secretary may review any determination by a school 
of nursing under subsection (c)(6)(B). 
"(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.". 
Deadlines. 
SEC. 204. REPORTS BY GENERAL ACCOUNTING OFFICE. 
42 u s e 296 note. 
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(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 determine national 
variations in the nursing shortage at hospitals, nursing homes, 
and other health care providers, and submit a report, including 
recommendations, to the Congress on Federal remedies to ease 
nursing shortages. The Comptroller General shall submit to the 
PUBLIC LAW 107-205—AUG. 1, 2002 
116 STAT. 819 
Congress this report describing the findings relating to ownership 
status and associated 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 shall submit to the Congress a report describing the 
findings of the study. 
(c) NURSING SCHOLARSHIPS.—The Comptroller General 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 enact-
ment of this Act, submit a report to the Congress on the results 
of such evaluation. 
Approved August 1, 2002. 
LEGISLATIVE HISTORY—H.R. 3487: 
CONGRESSIONAL RECORD: 
Vol. 147 (2001): Dec. 19, 20, considered and passed House. 
Vol. 148 (2002): July 22, considered and passed Senate, amended. House 
concurred in Senate amendment.