Title VIII Nursing Workforce Reauthorization Act of 2019

IIB 116TH CONGRESS 1ST SESSION H. R. 728 IN THE SENATE OF THE UNITED STATES OCTOBER 29, 2019 Received; read twice and referred to the Committee on Health, Education, Labor, and Pensions AN ACT 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 pur- poses. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 00:41 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H728.RFS H728 pamtmann on DSKBC07HB2PROD with BILLS 2 HR 728 RFS SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 1 (a) SHORT TITLE.—This Act may be cited as the 2 ‘‘Title VIII Nursing Workforce Reauthorization Act of 3 2019’’. 4 (b) TABLE OF CONTENTS.—The table of contents of 5 this Act is as follows: 6 Sec. 1. Short title; table of contents. Sec. 2. General provisions. Sec. 3. Nurse practitioners, nurse midwives, nurse anesthetists, and other ad- vanced 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. 7 (a) APPLICATION.—Section 802(c) of the Public 8 Health Service Act (42 U.S.C. 296a(c)) is amended by 9 striking ‘‘shall address relevant national nursing needs 10 that the project will meet’’ and inserting ‘‘shall address 11 relevant national nursing needs that the project will ad- 12 dress and how the project aligns with the national nursing 13 service goals referred to in section 806(a)’’. 14 (b) USE OF FUNDS.—Section 803 of the Public 15 Health Service Act (42 U.S.C. 296b) is amended by add- 16 ing at the end the following: 17 ‘‘(c) SUPPLEMENT NOT SUPPLANT.—Funds awarded 18 as a grant under this title for a project or activity shall 19 be used to supplement, not supplant, the non-Federal 20 VerDate Sep 11 2014 00:41 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H728.RFS H728 pamtmann on DSKBC07HB2PROD with BILLS 3 HR 728 RFS funds that would otherwise be made available for such 1 project or activity.’’. 2 (c) GENERALLY APPLICABLE PROVISIONS.—Section 3 806 of the Public Health Service Act (42 U.S.C. 296e) 4 is amended— 5 (1) in subsection (b), by amending paragraph 6 (2) to read as follows: 7 ‘‘(2) EVALUATIONS.—The Secretary shall es- 8 tablish procedures to ensure the annual evaluation of 9 programs and projects operated by recipients of 10 grants under this title. Such procedures shall ensure 11 that continued funding for such programs and 12 projects will be conditioned upon the submission 13 of— 14 ‘‘(A) data demonstrating that satisfactory 15 progress has been made by the program or 16 project in meeting the performance outcome 17 standards (as described in section 802) of such 18 program or project; and 19 ‘‘(B) a detailed description of activities 20 conducted by such program or project to meet 21 such performance outcome standards.’’; 22 (2) in subsection (e)(2), by inserting ‘‘, and 23 have relevant expertise and experience’’ after ‘‘who 24 VerDate Sep 11 2014 00:41 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H728.RFS H728 pamtmann on DSKBC07HB2PROD with BILLS 4 HR 728 RFS are not officers or employees of the Federal Govern- 1 ment’’; and 2 (3) by adding at the end the following: 3 ‘‘(i) ANNUAL REPORT ON NURSING WORKFORCE 4 PROGRAMS.—Annually, the Secretary shall submit to the 5 Committee on Health, Education, Labor, and Pensions of 6 the Senate, and the Committee on Energy and Commerce 7 of the House of Representatives, a report containing an 8 assessment of the programs and activities of the Depart- 9 ment of Health and Human Services related to enhancing 10 the nursing workforce, including the extent to which pro- 11 grams and activities under this title meet identified goals 12 and performance measures developed for the respective 13 programs and activities.’’. 14 SEC. 3. NURSE PRACTITIONERS, NURSE MIDWIVES, NURSE 15 ANESTHETISTS, AND OTHER ADVANCED EDU- 16 CATION NURSES. 17 Section 811 of the Public Health Service Act (42 18 U.S.C. 296j) is amended— 19 (1) in subsection (b)— 20 (A) by striking ‘‘R.N./Master’s’’ and in- 21 serting ‘‘R.N./graduate’’; and 22 (B) by inserting ‘‘clinical nurse leaders,’’ 23 before ‘‘or public health nurses’’; 24 VerDate Sep 11 2014 00:41 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H728.RFS H728 pamtmann on DSKBC07HB2PROD with BILLS 5 HR 728 RFS (2) by redesignating subsections (f) and (g) as 1 subsections (g) and (h), respectively; 2 (3) by inserting after subsection (e) the fol- 3 lowing new subsection: 4 ‘‘(f) AUTHORIZED CLINICAL NURSE SPECIALIST 5 PROGRAMS.—Clinical nurse specialist programs eligible 6 for support under this section are education programs 7 that— 8 ‘‘(1) provide registered nurses with full-time 9 clinical nurse specialist education; and 10 ‘‘(2) have as their objective the education of 11 clinical nurse specialists who will upon completion of 12 such a program be qualified to effectively provide 13 care through the wellness and illness continuum to 14 inpatients and outpatients experiencing acute and 15 chronic illness.’’; and 16 (4) by adding at the end the following: 17 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There 18 are authorized to be appropriated to carry out this section 19 $77,585,000 for each of fiscal years 2020 through 2024.’’. 20 SEC. 4. INCREASING NURSING WORKFORCE DIVERSITY. 21 Section 821 of the Public Health Service Act (42 22 U.S.C. 296m) is amended by adding at the end the fol- 23 lowing: 24 VerDate Sep 11 2014 00:41 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H728.RFS H728 pamtmann on DSKBC07HB2PROD with BILLS 6 HR 728 RFS ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 1 are authorized to be appropriated to carry out this section 2 $18,037,000 for each of fiscal years 2020 through 2024.’’. 3 SEC. 5. STRENGTHENING CAPACITY FOR BASIC NURSE 4 EDUCATION AND PRACTICE. 5 (a) NURSE EDUCATION, PRACTICE, QUALITY, AND 6 RETENTION GRANTS.—Section 831 of the Public Health 7 Service Act (42 U.S.C. 296p) is amended— 8 (1) in the section heading, by striking ‘‘AND 9 QUALITY’’ and inserting ‘‘QUALITY, AND RETEN- 10 TION’’; 11 (2) in subsection (b), by amending paragraph 12 (2) to read as follows: 13 ‘‘(2) providing care for underserved populations 14 and high-risk groups, which may include the elderly, 15 individuals with HIV/AIDS, individuals with mental 16 health or substance use disorders, individuals who 17 are homeless, and victims and survivors of domestic 18 violence;’’; 19 (3) in subsection (c), by amending paragraph 20 (1) to read as follows: 21 ‘‘(1) GRANTS FOR CAREER LADDER PRO- 22 GRAMS.—The Secretary may award grants to and 23 enter into contracts with eligible entities for pro- 24 grams— 25 VerDate Sep 11 2014 00:41 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H728.RFS H728 pamtmann on DSKBC07HB2PROD with BILLS 7 HR 728 RFS ‘‘(A) to promote career advancement for— 1 ‘‘(i) nursing personnel in a variety of 2 training settings, cross training or spe- 3 cialty training among diverse population 4 groups, and the advancement of individ- 5 uals, including to become professional reg- 6 istered nurses, advanced practice reg- 7 istered nurses, and nurses with graduate 8 nursing education; and 9 ‘‘(ii) individuals, including licensed 10 practical nurses, licensed vocational nurses, 11 certified nurse assistants, and diploma de- 12 gree or associate degree nurses, to become 13 baccalaureate-prepared registered nurses 14 or nurses with graduate nursing education; 15 ‘‘(B) to assist individuals in obtaining edu- 16 cation and training required to enter the nurs- 17 ing profession and advance within such profes- 18 sion, such as by providing career counseling and 19 mentoring; and 20 ‘‘(C) to develop and implement internships, 21 accredited fellowships, and accredited residency 22 programs in collaboration with one or more ac- 23 credited schools of nursing to encourage men- 24 toring and development of specialties.’’; 25 VerDate Sep 11 2014 00:41 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H728.RFS H728 pamtmann on DSKBC07HB2PROD with BILLS 8 HR 728 RFS (4) by striking subsection (e) (relating to pref- 1 erence); 2 (5) by redesignating subsections (f) through (h) 3 as subsections (e) and (g), respectively; 4 (6) in subsection (e), as so redesignated, by 5 striking ‘‘The Secretary shall submit to the Congress 6 before the end of each fiscal year a’’ and inserting 7 ‘‘As part of the report on nursing workforce pro- 8 grams described in section 806(i), the Secretary 9 shall’’; 10 (7) by amending subsection (f), as redesignated 11 by paragraph (5), to read as follows: 12 ‘‘(f) DEFINITIONS.—For purposes of this section: 13 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en- 14 tity’ includes an accredited school of nursing, a 15 health care facility, a partnership of such a school 16 and facility, a federally qualified health center, or a 17 nurse-managed health clinic. 18 ‘‘(2) NURSE-MANAGED HEALTH CLINIC.—The 19 term ‘nurse-managed health clinic’ means a nurse- 20 practice arrangement, managed by advanced practice 21 nurses, that provides primary care or wellness serv- 22 ices to underserved or vulnerable populations that is 23 associated with a school, college, university or de- 24 partment of nursing, federally qualified health cen- 25 VerDate Sep 11 2014 00:41 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H728.RFS H728 pamtmann on DSKBC07HB2PROD with BILLS 9 HR 728 RFS ter, or independent nonprofit health or social serv- 1 ices agency.’’; and 2 (8) in subsection (g), as redesignated by para- 3 graph (5), by striking ‘‘such sums as may be nec- 4 essary for each of fiscal years 2010 through 2014’’ 5 and inserting ‘‘$43,590,000 for each of fiscal years 6 2020 through 2024’’. 7 (b) NURSE RETENTION GRANTS.—Section 831A of 8 the Public Health Service Act (42 U.S.C. 296p–1) is re- 9 pealed. 10 SEC. 6. STUDENT LOANS. 11 (a) LOAN REPAYMENT AND SCHOLARSHIP PRO- 12 GRAMS.—Section 846 of the Public Health Service Act (42 13 U.S.C. 297n) is amended— 14 (1) in subsection (b)(1), by striking ‘‘he began 15 such practice’’ and inserting ‘‘the individual began 16 such practice’’; 17 (2) in subsection (d)(1), by striking ‘‘(for fiscal 18 years 2003 and 2004) and may (for fiscal years 19 thereafter)’’; 20 (3) in subsection (h), in the matter preceding 21 paragraph (1), by striking ‘‘Not later than’’ through 22 ‘‘regarding’’ and inserting ‘‘The annual report on 23 nursing workforce programs, as required by section 24 806(i), shall include information regarding the pro- 25 VerDate Sep 11 2014 00:41 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H728.RFS H728 pamtmann on DSKBC07HB2PROD with BILLS 10 HR 728 RFS grams carried out under this section, including’’; 1 and 2 (4) in subsection (i)(1), by striking ‘‘such sums 3 as may be necessary for each of fiscal years 2003 4 through 2007’’ and inserting ‘‘$90,620,000 for each 5 of fiscal years 2020 through 2024’’. 6 (b) NURSE FACULTY LOAN PROGRAM.—Section 7 846A(f) of the Public Health Service Act (42 U.S.C. 8 297n–1(f)) is amended by striking ‘‘such sums as may be 9 necessary for each of fiscal years 2010 through 2014’’ and 10 inserting ‘‘$29,640,000 for each of fiscal years 2020 11 through 2024’’. 12 SEC. 7. NATIONAL ADVISORY COUNCIL ON NURSE EDU- 13 CATION AND PRACTICE. 14 Section 851 of the Public Health Service Act (42 15 U.S.C. 297t) is amended— 16 (1) in subsection (b)(1)(A)(iv), by striking ‘‘and 17 nurse anesthetists’’ and inserting ‘‘nurse anes- 18 thetists, and clinical nurse specialists’’; 19 (2) in subsection (d), by amending paragraph 20 (3) to read as follows: 21 ‘‘(3) not later than 2 years after the date of en- 22 actment of the Title VIII Nursing Workforce Reau- 23 thorization Act of 2019, and every 2 years there- 24 after, prepare and submit to the Secretary, the Com- 25 VerDate Sep 11 2014 00:41 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H728.RFS H728 pamtmann on DSKBC07HB2PROD with BILLS 11 HR 728 RFS mittee on Health, Education, Labor, and Pensions 1 of the Senate, and the Committee on Energy and 2 Commerce of the House of Representatives, a report 3 describing the activities of the Council, including 4 findings and recommendations made by the Council 5 concerning the activities under this title.’’; and 6 (3) in subsection (g), by striking ‘‘under this 7 title’’ and inserting ‘‘for carrying out parts B, C, 8 and D of this title’’. 9 SEC. 8. OTHER PROVISIONS. 10 (a) PUBLIC SERVICE ANNOUNCEMENTS.—Part G of 11 title VIII of the Public Health Service Act (42 U.S.C. 12 297w et seq.) is repealed. 13 (b) FUNDING.—Part I of title VIII of the Public 14 Health Service Act (42 U.S.C. 298d) is repealed. 15 (c) ELIMINATING LIMITATION ON ASSIGNMENT.— 16 Section 846(a) of the Public Health Service Act (42 17 U.S.C. 297n(a)) is amended, in the matter following para- 18 graph (3), by striking ‘‘After fiscal year 2007,’’ and all 19 that follows through the period at the end. 20 Passed the House of Representatives October 28, 2019. Attest: CHERYL L. JOHNSON, Clerk. VerDate Sep 11 2014 00:41 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H728.RFS H728 pamtmann on DSKBC07HB2PROD with BILLS