SPECIAL PROJECT GRANTS AND CONTRACTS.

SEC. 701. SPECIAL PROJECT GRANTS AND CONTRACTS. (a) Transfer of Program for Individuals From Disadvantaged Backgrounds.—Part A of title VIII (42 U.S.C. 296k et seq.) is amended— (1) by inserting after the heading for such part the following new heading: “Subpart I—Special Projects in General”, (2) by striking section 820(a)(1), and (3) by adding at the end the following new subpart: “Subpart II—Nursing Education Opportunities for Individuals From Disadvantaged Backgrounds “special projects “Sec. 827. (a) The Secretary may make grants to public and nonprofit private schools of nursing and other public or nonprofit private entities, and enter into contracts with any public or private entity, to meet the costs of special projects to increase nursing education opportunities for individuals from disadvantaged back-grounds, as determined in accordance with criteria prescribed by the Secretary— “(1) by identifying, recruiting, and selecting such individuals, “(2) by facilitating the entry of such individuals into schools of nursing, “(3) by providing counseling or other services designed to assist such individuals to complete successfully their nursing education, “(4) by providing, for a period prior to the entry of such individuals into the regular course of education at a school of nursing, preliminary education designed to assist them to complete successfully such regular course of education, 102 STAT. 3154 “(5) by paying such stipends (including allowances for travel and dependents) as the Secretary may determine for such individuals for any period of nursing education, “(6) by publicizing, especially to licensed vocational or practical nurses, existing sources of financial aid available to per-sons enrolled in schools of nursing or who are undertaking training necessary to qualify them to enroll in such schools, and “(7) by providing training, information, or advice to the faculty of such schools with respect to encouraging such individuals to complete the programs of nursing education in which the individuals are enrolled. “(b) No grant or contract may be made under this section unless an application therefor has been submitted to and approved by the Secretary. The Secretary may not approve or disapprove such an application except after consultation with the National Advisory Council on Nurse Education. Such an application shall provide for such fiscal control and accounting procedures and reports, and access to the records of the applicant, as the Secretary may require to assure proper disbursement of and accounting for Federal funds paid to the applicant under this section. “(c) For payments under grants and contracts under subsection (a), there are authorized to be appropriated $3,000,000 for fiscal year 1989, $4,000,000 for fiscal year 1990, and $5,000,000 for fiscal year 1991.”. (b) Striking of Certain Programs.—Section 820(a) (42 U.S.C. 296k(a)) is amended— (1) by striking paragraphs (3), (7), and (9), and (2) by redesignating paragraphs (2), (4), (5), (6), and (8) as paragraphs (1) through (5), respectively. (c) Geriatric Training.—Section 820(a)(2) (as redesignated by subsection (b)(2) of this section) is amended to read as follows— “(2) demonstrate, through geriatric health education centers and other entities, improved geriatric training in preventive care, acute care, and long-term care (including home health care and institutional care);”. (d) Upgrading Skills.—Section 820(a) (42 U.S.C. 296k(a)) is amended— (1) by amending paragraph (3) (as redesignated by subsection (b)(2) of this section) to read as follows: “(3)(A) increase the supply of adequately trained nursing personnel (including bilingual nursing personnel) to meet the health needs of rural areas; and “(B) provide nursing education courses to rural areas through telecommunications via satellite;”, and (2) by amending paragraph (4) (as so redesignated) to read as follows: “(4) provide training and education— “(A) to upgrade the skills of licensed vocational or practical nurses, nursing assistants, and other paraprofessional nursing personnel with priority given to rapid transition programs toward achievement of professional nursing degrees; and “(B) to develop curricula for the achievement of baccalaureate degrees in nursing by registered nurses and by individuals with baccalaureate degrees in other fields;”. (e) Coordination Projects With Respect to Loan Repayments for Service in Health Faciuties.—Section 820(a) (42 U.S.C. 102 STAT. 3155296k(a)) is amended by adding after paragraph (5) (as redesignated by subsection (b)(2) of this section) the following new paragraph: “(6)(A) collect the names and addresses of health facilities willing to enter into agreements with nursing students and nursing personnel under which such individuals agree to serve as nurses in the health facilities in consideration of the health facilities agreeing to repay the principal and interest of the educational loans of such individuals; “(B) collect data on the specific terms of such agreements offered by health facilities; “(C) collect the names and addresses of nursing students identified pursuant to section 827(a), of other nursing students, and of nursing personnel, willing to enter into such agreements; and “(D) coordinate and facilitate communications between health facilities and such individuals with respect to such agreements.”. (f) Geriatric Health Education Centers.—Section 820 (42 U.S.C. 296k) is amended— (1) by redesignating subsections (b) through (d) as subsections (e) through (g), respectively, and (2) by adding after subsection (a) the following new subsection: “(b)(1) The Secretary may make grants to, and enter into contracts with, accredited schools of nursing to assist in meeting the costs of such schools in providing projects— “(A) to improve the training of nurses in geriatrics; “(B) to develop and disseminate curricula relating to the treatment of the health problems of elderly individuals; “(C) to expand and strengthen instruction in methods of such treatment; “(D) to support the training and retraining of faculty to provide such instruction; “(E) to support continuing education of nurses who provide such treatment; and “(F) to establish new affiliations with nursing homes, chronic and acute disease hospitals, ambulatory care centers, and senior centers in order to provide students with clinical training in geriatric health care. “(2)(A) Any application for a grant or contract under this subsection shall be subject to appropriate peer review by peer review groups composed principally of non-Federal experts. “(B) The Secretary may not approve or disapprove an application for a grant or contract under this subsection unless the Secretary has received recommendations with respect to such application from the appropriate peer review group required under paragraph (1) and has consulted with the Advisory Council on Nurses Education with respect to such application. “(C) For the purpose of carrying out this subsection, the Secretary may obligate each fiscal year not more than $2,000,000 of the amounts made available for such purpose pursuant to subsection (g)(2).”. (g) Innovative Hospital Nursing Practice Models.—Section 820 (42 U.S.C. 296k), as amended by subsection (f) of this section, is further amended by inserting after subsection (b) the following new subsection: “(c)(1) The Secretary may make grants to public and nonprofit private entities for the purpose of demonstrating innovative hospital 102 STAT. 3156nursing practice models designed to reduce vacancies in professional nursing positions and to make such positions a more attractive career choice. “(2) The Secretary may not make a grant under paragraph (1) unless the applicant for the grant agrees that hospital nursing practice models demonstrated pursuant to such subsection will include initiatives— “(A) to restructure the role of the professional nurse, through changes in the composition of hospital staffs and through innovative approaches for interaction between hospital administration and nursing personnel, in order to ensure that the particular expertise of such nurses is efficiently utilized and that such nurses are engaged in direct patient care during a larger proportion of their work time; “(B) to test innovative wage structures for professional nurses in order to— “(i) reduce vacancies in work shifts during unpopular work hours; and “(ii) provide financial recognition based upon experience and education; and “(C) to evaluate the effectiveness of providing benefits for professional nurses, such as pensions, sabbaticals, and payment of educational expenses, as a means of developing increased loyalty of such nurses to health care institutions and reducing turnover in nursing positions.”. (h) Long-Term Care Nursing Practice Demonstrations.—Section 820 (42 U.S.C. 296k), as amended by subsection (g) of this section, is further amended by inserting after subsection (c) the following new subsection: “(d)(1) The Secretary may make grants to public and nonprofit private entities accredited for the training of nurses for the purpose of— “(A) demonstrating innovative nursing practice models for— “(i) the provision of case-managed health care services (including adult day care) and health care services in the home; or “(ii) the provision of health care services in long-term care facilities; or “(B) developing projects to increase the exposure of nursing students to clinical practice in nursing home, home health, and gérontologie settings through collaboration between such accredited entities and entities that provide health care in such settings. “(2) The Secretary may not make a grant under paragraph (1) unless the applicant for the grant agrees that models demonstrated pursuant to such paragraph will be designed— “(A) to increase the recruitment and retention of nurses to provide nursing care for individuals needing long-term care; and “(B) to improve nursing care in home health care settings and nursing homes.”. (i) Authorization of Appropriations.—Section 820(g) (as redesignated by subsection (b)(2) of this section) is amended to read as follows: “(g)(1) For payments under grants and contracts under this section, there are authorized to be appropriated $13,000,000 for fiscal 102 STAT. 3157year 1989, $16,000,000 for fiscal year 1990, and $20,000,000 for fiscal year 1991. “(2) Of the amounts appropriated pursuant to paragraph (1), the Secretary shall obligate not less than 20 percent to carry out subsection (a)(2) and subsection (b) (subject to subsection (b)(2)(D), not less than 20 percent to carry out paragraph (3) of subsection (a), and not less than 10 percent to carry out paragraph (4) of such subsection. Of the amounts appropriated pursuant to paragraph (1) for fiscal year 1989, the Secretary shall obligate not less than 20 percent to carry out section 827.”.