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H.R. 959 — what changed

Title VIII Nursing Workforce Reauthorization Act of 2018

From Introduced in House to Engrossed in House. 3 sections amended and 5 added between Introduced in House and Engrossed in House.

Section 1 Short title; table of contents

(a)
added Short title— This Act may be cited as the “Title VIII Nursing Workforce Reauthorization Act of 2018”.
(b)
added Table of contents— The table of contents of this Act is as follows:

removed This Act may be cited as the “Title VIII Nursing Workforce Reauthorization Act of 2017”.

Sec. 2 General provisions

(a)
changed Advanced education nursing grants—Application— Section 811 802(c) of the Public Health Service Act (42 U.S.C. 296j) 296a(c)) is amended—amended by striking “shall address relevant national nursing needs that the project will meet” and inserting “shall address relevant national nursing needs that the project will address and how the project aligns with the national nursing service goals referred to in section 806(a)”.
(1)
removed in subsection (b)—
(A)
removed by striking “R.N./Master’s” and inserting “R.N./graduate”; and
(B)
removed by inserting “clinical nurse leaders,” before “or public health nurses”;
(2)
removed by redesignating subsections (f) and (g) as subsections (g) and (h), respectively; and
(3)
removed by inserting after subsection (e) the following new subsection:

removed “(f) Authorized clinical nurse specialist programs—Clinical nurse specialist programs eligible for support under this section are education programs that—

removed “(1) provide registered nurses with full-time clinical nurse specialist education; and

removed “(2) have as their objective the education of clinical nurse specialists who will upon completion of such a program be qualified to effectively provide care through the wellness and illness continuum to inpatients and outpatients experiencing acute and chronic illness.”

(b)
changed Definition Use of nurse-Managed health clinic—funds— Section 801 803 of the Public Health Service Act (42 U.S.C. 296) 296b) is amended by adding at the end the following:

changed “(18) Nurse-managed health clinic—The term nurse-managed health clinic means “(c) Supplement not supplant—Funds awarded as a nurse-practice arrangement, managed by advanced practice nurses, that provides primary care grant under this title for a project or wellness services activity shall be used to underserved or vulnerable populations and supplement, not supplant, the non-Federal funds that is associated with a school, college, university or department of nursing, federally qualified health center, or independent nonprofit health would otherwise be made available for such project or social services agency.”activity.”

(c)
changed National Advisory Council on Nurse Education and Practice—Generally applicable provisions— Section 851(b)(1)(A)(iv) 806 of the Public Health Service Act (42 U.S.C. 297t(b)(1)(A)(iv)) 296e) is amended by striking “and nurse anesthetists” and inserting “nurse anesthetists, and clinical nurse specialists”.amended—
(1)
added in subsection (b), by amending paragraph (2) to read as follows:

added “(2) Evaluations—The Secretary shall establish procedures to ensure the annual evaluation of programs and projects operated by recipients of grants under this title. Such procedures shall ensure that continued funding for such programs and projects will be conditioned upon the submission of—

added “(A) data demonstrating that satisfactory progress has been made by the program or project in meeting the performance outcome standards (as described in section 802) of such program or project; and

added “(B) a detailed description of activities conducted by such program or project to meet such performance outcome standards.”

(2)
added in subsection (e)(2), by inserting “, and have relevant expertise and experience” after “who are not officers or employees of the Federal Government”; and
(3)
added by adding at the end the following:

added “(i) Annual report on nursing workforce programs—Annually, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate, and the Committee on Energy and Commerce of the House of Representatives, a report containing an assessment of the programs and activities of the Department of Health and Human Services related to enhancing the nursing workforce, including the extent to which programs and activities under this title meet identified goals and performance measures developed for the respective programs and activities.”

Sec. 3 Nurse practitioners, nurse midwives, nurse anesthetists, and other advanced education nurses

added Section 811 of the Public Health Service Act (42 U.S.C. 296j) is amended—

(a)
removed In general— Title VIII of the Public Health Service Act (42 U.S.C. 296 et seq.) is amended—
(1)
removed in subsection (i)(1) of section 846 (42 U.S.C. 297n; loan repayment and scholarship programs), by striking “2007” and inserting “2022”;
(2)
removed in subsection (f) of section 846A (42 U.S.C. 297n–1; nurse faculty loan program), by striking “2014” and inserting “2022”;
(3)
removed in subsection (e) of section 865 (42 U.S.C. 298; comprehensive geriatric education), by striking “2014” and inserting “2022”; and
(4)
removed in section 871 (42 U.S.C. 298d; funding for carrying out parts B and C and section 831)—
(A)
removed by striking “2016” and inserting “2022”; and
(B)
removed by striking “B, C, and D” and inserting “B and C and section 831”.
(1)
changed Nurse Education, Practice, Quality, and Retention Grants— Section 831 of the Public Health Service Act (42 U.S.C. 296p) is amended—in subsection (b)—
(A)
added by striking “R.N./Master’s” and inserting “R.N./graduate”; and
(B)
changed in the section heading, by striking “and quality” and inserting “quality, and retention”;“clinical nurse leaders,” before “or public health nurses”;
(2)
added by redesignating subsections (f) and (g) as subsections (g) and (h), respectively;
(3)
added by inserting after subsection (e) the following new subsection:

added “(f) Authorized clinical nurse specialist programs—Clinical nurse specialist programs eligible for support under this section are education programs that—

added “(1) provide registered nurses with full-time clinical nurse specialist education; and

added “(2) have as their objective the education of clinical nurse specialists who will upon completion of such a program be qualified to effectively provide care through the wellness and illness continuum to inpatients and outpatients experiencing acute and chronic illness.”

(2)
removed in subsection (c)(1)—
(A)
removed by amending subparagraph (A) to read as follows:

removed “(A) to promote career advancement for—

removed “(i) nursing personnel in a variety of training settings, cross-training or specialty training among diverse population groups, and the advancement of individuals including to become professional nurses, advanced education nurses, licensed practical nurses, certified nurse assistants, and home health aides; and

removed “(ii) individuals including licensed practical nurses, licensed vocational nurses, certified nurse assistants, home health aides, diploma degree or associate degree nurses, to become baccalaureate prepared registered nurses or advanced education nurses in order to meet the needs of the registered nurse workforce;”

(B)
removed in subparagraph (B), by striking the period and inserting “; and”; and
(4)
renumbered was (3)(4)(4) by adding at the end the following:

added “(i) Authorization of appropriations—There are authorized to be appropriated to carry out this section $74,581,000 for each of fiscal years 2019 through 2023.”

removed “(C) developing and implementing internships and residency programs in collaboration with an accredited school of nursing, as defined by section 801(2), to encourage mentoring and the development of specialties.”

(3)
removed in subsection (g)—
(A)
removed by striking “,,” and inserting “,”;
(B)
removed by striking “or”; and
(C)
removed by inserting “, or a nurse-managed health clinic” before the period; and
(4)
removed by striking subsection (h).

Sec. 4 Increasing nursing workforce diversity

added

added Section 821 of the Public Health Service Act (42 U.S.C. 296m) is amended by adding at the end the following:

added “(d) Authorization of appropriations—There are authorized to be appropriated to carry out this section $17,343,000 for each of fiscal years 2019 through 2023.”

Sec. 5 Strengthening capacity for basic nurse education and practice

added
(a)
added Nurse education, practice, quality, and retention grants— Section 831 of the Public Health Service Act (42 U.S.C. 296p) is amended—
(1)
added in the section heading, by striking “and quality” and inserting “quality, and retention”;
(2)
added in subsection (b), by amending paragraph (2) to read as follows:

added “(2) providing care for underserved populations and high-risk groups, which may include the elderly, individuals with HIV/AIDS, individuals with mental health or substance use disorders, individuals who are homeless, and victims and survivors of domestic violence;”

(3)
added in subsection (c), by amending paragraph (1) to read as follows:

added “(1) Grants for career ladder programs—The Secretary may award grants to and enter into contracts with eligible entities for programs—

added “(A) to promote career advancement for—

added “(i) nursing personnel in a variety of training settings, cross training or specialty training among diverse population groups, and the advancement of individuals, including to become professional registered nurses, advanced practice registered nurses, and nurses with graduate nursing education; and

added “(ii) individuals, including licensed practical nurses, licensed vocational nurses, certified nurse assistants, and diploma degree or associate degree nurses, to become baccalaureate-prepared registered nurses or nurses with graduate nursing education;

added “(B) to assist individuals in obtaining education and training required to enter the nursing profession and advance within such profession, such as by providing career counseling and mentoring; and

added “(C) to develop and implement internships, accredited fellowships, and accredited residency programs in collaboration with one or more accredited schools of nursing to encourage mentoring and development of specialties.”

(4)
added by striking subsection (e) (relating to preference);
(5)
added by redesignating subsections (f) through (h) as subsections (e) and (g), respectively;
(6)
added in subsection (e), as so redesignated, by striking “The Secretary shall submit to the Congress before the end of each fiscal year a” and inserting “As part of the report on nursing workforce programs described in section 806(i), the Secretary shall”;
(7)
added by amending subsection (f), as redesignated by paragraph (5), to read as follows:

added “(f) Definitions—For purposes of this section:

added “(1) Eligible entity—The term eligible entity includes an accredited school of nursing, a health care facility, a partnership of such a school and facility, a federally qualified health center, or a nurse-managed health clinic.

added “(2) Nurse-managed health clinic—The term nurse-managed health clinic means a nurse-practice arrangement, managed by advanced practice nurses, that provides primary care or wellness services to underserved or vulnerable populations that is associated with a school, college, university or department of nursing, federally qualified health center, or independent nonprofit health or social services agency.”

(8)
added in subsection (g), as redesignated by paragraph (5), by striking “such sums as may be necessary for each of fiscal years 2010 through 2014” and inserting “$41,913,000 for each of fiscal years 2019 through 2023”.
(b)
added Nurse retention grants— Section 831A of the Public Health Service Act (42 U.S.C. 296p–1) is repealed.

Sec. 6 Student loans

added
(a)
added Loan repayment and scholarship programs— Section 846 of the Public Health Service Act (42 U.S.C. 297n) is amended—
(1)
added in subsection (b)(1), by striking “he began such practice” and inserting “the individual began such practice”;
(2)
added in subsection (d)(1), by striking “(for fiscal years 2003 and 2004) and may (for fiscal years thereafter)”;
(3)
added in subsection (h), in the matter preceding paragraph (1), by striking “Not later than” through “regarding” and inserting “The annual report on nursing workforce programs, as required by section 806(i), shall include information regarding the programs carried out under this section, including”; and
(4)
added in subsection (i)(1), by striking “such sums as may be necessary for each of fiscal years 2003 through 2007” and inserting “$87,135,000 for each of fiscal years 2019 through 2023”.
(b)
added Nurse faculty loan program— Section 846A of the Public Health Service Act (42 U.S.C. 297n–1) is amended by striking “such sums as may be necessary for each of fiscal years 2010 through 2014” and inserting “$28,500,000 for each of fiscal years 2019 through 2023”.

Sec. 7 National Advisory Council on Nurse Education and Practice

added

added Section 851 of the Public Health Service Act (42 U.S.C. 297t) is amended—

(1)
added in subsection (b)(1)(A)(iv), by striking “and nurse anesthetists” and inserting “nurse anesthetists, and clinical nurse specialists”;
(2)
added in subsection (d), by amending paragraph (3) to read as follows:

added “(3) not later than 2 years after the date of enactment of the Title VIII Nursing Workforce Reauthorization Act of 2018, and every 2 years thereafter, prepare and submit to the Secretary, the Committee on Health, Education, Labor, and Pensions of the Senate, and the Committee on Energy and Commerce of the House of Representatives, a report describing the activities of the Council, including findings and recommendations made by the Council concerning the activities under this title.”

(3)
added in subsection (g), by striking “under this title” and inserting “for carrying out parts B, C, and D of this title”.

Sec. 8 Other provisions

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