SPECIAL PROJECT GRANTS AND CONTRACTS.

SEC. 202. SPECIAL PROJECT GRANTS AND CONTRACTS. (a) In General.—Section 820 of the Public Health Service Act (42 U.S.C. 296k) is amended to read as follows: “special project grants and contracts “Sec. 820. (a) Expansion of Enrollment in Professional Nursing Programs.— “(1) In general.—The Secretary may make grants to and enter into contracts with public and nonprofit private schools of nursing with programs of education in professional nursing for the purpose of assisting the schools in increasing the number of students enrolled in such programs. Such a grant or contract may be made only with respect to such programs that are 106 STAT. 2070in operation on the date of the enactment of the Health Professions Education Extension Amendments of 1992. “(2) Preference.— In making awards of grants and contracts under paragraph (1), the Secretary shall give preference to any qualified school that provides students of the school with clinical training in the provision of primary health care in publicly-funded— “(A) urban or rural outpatient facilities, home health agencies, or public health agencies; or “(B) rural hospitals. “(3) Matching funds.— “(A) With respect to the costs of the program to be carried out by a school pursuant to paragraph (1), the Secretary may provide an award of a grant or contract under such paragraph only if the school agrees to make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount that— “(i) for the first fiscal year for which the school receives such an award, is not less than $1 for each $9 of Federal funds provided through the award (10 percent of such costs); “(ii) for any second such fiscal year, is not less than $1 for each $3 of Federal funds provided through the award (25 percent of such costs); “(iii) for any third such fiscal year, is not less than $1 for each $1 of Federal funds provided through the award (50 percent of such costs); and “(iv) for any fourth or fifth such fiscal year, is not less than $3 for each $1 of Federal funds provided through the award (75 percent of such costs). “(B) Non-Federal contributions required in subparagraph (A) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions. “(b) Primary Health Care in Noninstitutional Settings.— “(1) In general.—The Secretary may make grants to and enter into contracts with public and nonprofit private schools of nursing for the establishment or expansion of nursing practice arrangements in noninstitutional settings to demonstrate methods to improve access to primary health care in medically underserved communities. “(2) Operation and staffing of programs.—The Secretary may make an award of a grant or contract under paragraph (1) only if the school involved agrees that the program carried out with the award will be operated and staffed by the faculty and students of the school. “(3) Design.—The Secretary may make an award of a grant or contract under paragraph (1) only if the program to be carried out under such paragraph by the school involved is designed to provide at least 25 percent of the students of the school with a structured clinical experience in primary health care. 106 STAT. 2071 “(c) Continuing Education for Nurses in Medically Under-served Communities.—The Secretary may make grants to and enter into contracts with public and nonprofit private entities for the purpose of providing continuing education for nurses serving in medically underserved communities. “(d) Long-Term Care Fellowships for Certain Paraprofessionals.— “(1) In general.—The Secretary may make grants to and enter into contracts with public and nonprofit private entities that operate accredited programs of education in professional nursing, or State-board approved programs of practical or vocational nursing, for the purpose of providing fellowships to individuals described in paragraph (2) for attendance in such programs. “(2) Eligible individuals.—The individuals referred to in paragraph (1) are individuals who are employed by nursing facilities or home health agencies as nursing paraprofessionals. “(3) Preference for schools with rapid transition programs.—In making awards of grants and contracts under paragraph (1), the Secretary shall give preference to any qualified applicant operating an accredited program of education in professional nursing that provides for the rapid transition to status as a professional nurse from status as a nursing para-professional. “(4) Preference in award of fellowships.— The Secretary may make an award of a grant or contract under paragraph (1) only if the applicant involved agrees that, in providing fellowships under the award, the applicant will-give preference to individuals described in paragraph (2) who— “(A) are economically disadvantaged individuals, particularly such individuals who are members of a minority group that is underrepresented among registered nurses; or “(B) are employed by a nursing facility that will assist in paying the costs or expenses described in paragraph (5)(A) with respect to the individuals. “(5) Use of award.— The Secretary may make an award of a grant or contract under paragraph (1) only if the applicant involved agrees that fellowships provided with the award will pay all or part of the costs of— “(A) the tuition, books, and fees of the program of nursing with respect to which the fellowship is provided; and “(B) reasonable living expenses of the individual during the period for which the fellowship is provided. “(6) Definition.— For purposes of this section: “(A) The term ‘home health agency’ has the meaning given such term in section 1861 of the Social Security ct. “(B) The term ‘nursing facility’ has the meaning given such term in section 1919 of the Social Security Act. “(e) Authorization of Appropriations.—For the purpose of carrying out this section, there is authorized to be appropriated $10,500,000 for each of the fiscal years 1993 and 1994.”. (b) Definition of Medically Underserved Communities.—Section 853 of the Public Health Service Act (42 U.S.C. 298b) is amended by adding at the end the following new paragraph:106 STAT. 2072 “(11) The term “medically underserved community’ has the meaning given such term in section 799.”. (c) Savings Provision for Current Projects.—In the case of any authority for making awards of grants or contracts that is terminated by the amendment made by subsection (a), the Secretary of Health and Human Services may, notwithstanding the termination of the authority, continue in effect any grant or contract made under the authority that is in effect on the day before the date of the enactment of this Act, subject to the duration of any such grant or contract not exceeding the period determined by the Secretary in first approving such financial assistance, or in approving the most recent request made (before the date of such enactment) for continuation of such assistance, as the case may be.