NURSING.

SEC. 104. NURSING. (a) Continuing Education Allowances.—Section 106(a) of the Act (25 U.S.C. 1615(a)) is amended by inserting “nurses,” after “dentists,”. (b) Quentin N. Burdick American Indians Into Nursing Program.—Section 112 of the Act (25 U.S.C. 1616e) is amended— (1) by redesignating subsections (e) and (f) as subsections (f) and (g), respectively; and (2) by inserting after subsection (d) the following new subsection: “(e) The Secretary shall provide one of the grants authorized under subsection (a) to establish and maintain a program at the University of North Dakota to be known as the ‘Quentin N. Burdick American Indians Into Nursing Program’. Such program shall, to the maximum extent feasible, coordinate with the Quentin N. Burdick Indian Health Programs established under section 114(b) and the Quentin N. Burdick American Indians Into Psychology Program established under section 217(b).”. (c) Training for Nurse Midwives, Nurse Anesthetists, and Nurse Practitioners.—Section 112(g) of the Act (25 U.S.C. 1616e(g)) (as redesignated by subsection (b)(1) of this section) is amended to read as follows: “(g) Beginning with fiscal year 1993, of the amounts appropriated under the authority of this title for each fiscal year to be used to carry out this section, not less than $1,000,000 shall be used to provide grants under subsection (a) for the training of nurse midwives, nurse anesthetists, and nurse practitioners.”. (d) Retention Bonus for Nurses.—Section 117 (25 U.S.C. 1616j) of the Act is amended— (1) by redesignating subsections (b) through (e) as subsections (c) through (f), respectively; (2) by adding after subsection (a) the following new subsection (b): “(b) Beginning with fiscal year 1993, not less than 25 percent of the retention bonuses awarded each year under subsection (a) shall be awarded to nurses.”; and (3) by amending subsection (f) (as amended by paragraph (1)) to read as follows: “(f) The Secretary may pay a retention bonus to any physician or nurse employed by an organization providing health care services to Indians pursuant to a contract under the Indian Self-Determination Act if such physician or nurse is serving in a position which the Secretary determines is— 106 STAT. 4534 “(1) a position for which recruitment or retention is difficult; and “(2) necessary for providing health care services to Indians.”. (e) Residency Program.—Title I of the Act is amended by adding at the end the following new section: “nursing residency program “Sec. 118. (a) The Secretary, acting through the Service, shall establish a program to enable licensed practical nurses, licensed vocational nurses, and registered nurses who are working in an Indian health program (as defined in section 108(a)(2)(A)), and have done so for a period of not less than one year, to pursue advanced training. “(b) Such program shall include a combination of education and work study in an Indian health program (as defined in section 108(a)(2)(A)) leading to an associate or bachelor’s degree (in the case of a licensed practical nurse or licensed vocational nurse) or a bachelor’s degree (in the case of a registered nurse). “(c) An individual who participates in a program under subsection (a), where the educational costs are paid by the Service, shall incur an obligation to serve in an Indian health program for a period of obligated service equal to at least three times the period of time during which the individual participates in such program. In the event that the individual fails to complete such obligated service, the United States shall be entitled to recover from such individual an amount determined in accordance with the formula specified in subsection (1) of section 108 in the manner provided for in such subsection.”. (f) Grants for the Provision of Primary Care Services on or Near Indian Country.—Title I of the Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.) is amended by adding immediately after section 112 the following new section: “nursing school clinics “Sec. 112A. (a) Grants.—In addition to the authority of the Secretary under section 112(a)(1), the Secretary, acting through the Service, is authorized to provide grants to public or private schools of nursing for the purpose of establishing, developing, operating, and administering clinics to address the health care needs of Indians, and to provide primary health care services to Indians who reside on or within 50 miles of Indian country, as defined in section 1151 of title 18, United States Code. “(b) Purposes.—Grants provided under subsection (a) may be used to— “(1) establish clinics, to be run and staffed by the faculty and students of a grantee school, to provide primary care services in areas in or within 50 miles of Indian country (as defined in section 1151 of title 18, United States Code); “(2) provide clinical training, program development, faculty enhancement, and student scholarships in a manner that would benefit such clinics; and “(3) carry out any other activities determined appropriate by the Secretary. 106 STAT. 4535 “(c) Amount and Conditions.—The Secretary may award grants under this section in such amounts and subject to such conditions as the Secretary deems appropriate. “(d) Design.—The clinics established under this section shall be designed to provide nursing students with a structured clinical experience that is similar in nature to that provided by residency training programs for physicians. “(e) Regulations.—The Secretary shall prescribe such regulations as may be necessary to carry out the provisions of this section. “(f) Authorization To Use Amounts.—Out of amounts appropriated to carry out this title for each of the fiscal years 1993 through 2000 not more than $5,000,000 may be used to carry out this section.”.