§296k. Special project grants and contracts

(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 in operation on October 13, 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.

(c) Continuing education for nurses in medically underserved 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 paraprofessional.

(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) Definitions

For purposes of this section:

(A) The term "home health agency" has the meaning given such term in section 1395x of this title.

(B) The term "nursing facility" has the meaning given such term in section 1396r of this title.

(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.

(July 1, 1944, ch. 373, title VIII, §820, as added July 29, 1975, Pub. L. 94–63, title IX, §931(a), 89 Stat. 359 ; amended Sept. 29, 1979, Pub. L. 96–76, title I, §105, 93 Stat. 579 ; Aug. 13, 1981, Pub. L. 97–35, title XXVII, §2753(a)(1), (b), 95 Stat. 929 ; Aug. 16, 1985, Pub. L. 99–92, §3, 99 Stat. 393 ; Oct. 22, 1985, Pub. L. 99–129, title II, §227(a), 99 Stat. 547 ; Nov. 4, 1988, Pub. L. 100–607, title VII, §§701(a)(2), (b)–(i), 721(b)(1), 102 Stat. 3153–3156 , 3165; Oct. 13, 1992, Pub. L. 102–408, title II, §202(a), 106 Stat. 2069 ; Oct. 27, 1992, Pub. L. 102–531, title III, §313(a)(9), 106 Stat. 3507 .)

Amendments

1992-Pub. L. 102–531, which directed the substitution of "nursing with respect to" for "nursing respect to" in subsec. (d)(5)(A), could not be executed because the phrase "nursing respect to" did not appear in text.

Pub. L. 102–408 amended section generally, substituting present provisions for provisions relating to grants and contracts for special projects including geriatric health education centers, innovative hospital nursing practice models, and long-term nursing practice demonstrations, and further providing for utilization of medical facilities by Federal departments and agencies for nurse training programs, submission and approval of application for grants and contracts, and authorization of appropriations.

1988-Subsec. (a)(1). Pub. L. 100–607, §701(a)(2), (b)(2), redesignated par. (2) as (1) and struck out former par. (1) which related to nursing education opportunities for individuals from disadvantaged backgrounds.

Subsec. (a)(2). Pub. L. 100–607, §701(b)(2), (c), redesignated par. (4) as (2) and amended it generally. Prior to amendment, such par. read as follows: "demonstrate improved geriatric training in preventive care, acute care, and long-term care (including home health care and institutional care);". Former par. (2) redesignated (1).

Subsec. (a)(3). Pub. L. 100–607, §701(b)(2), (d)(1), redesignated par. (5) as (3) and amended it generally. Prior to amendment, such par. read as follows: "help to increase the supply or improve the distribution by geographic area or by specialty group of adequately trained nursing personnel (including nursing personnel who are bilingual) needed to meet the health needs of the Nation, including the need to increase the availability of personal health services and the need to promote preventive health care;".

Pub. L. 100–607, §701(b)(1), struck out former par. (3) which related to appropriate retraining opportunities for nurses who (after periods of professional inactivity) desire again actively to engage in the nursing profession.

Subsec. (a)(4). Pub. L. 100–607, §701(b)(2), (d)(2), redesignated par. (6) as (4) and amended it generally. Prior to amendment, such par. read as follows: "provide training and education to upgrade the skills of licensed vocational or practical nurses, nursing assistants, and other paraprofessional nursing personnel;". Former par. (4) redesignated (2).

Subsec. (a)(5). Pub. L. 100–607, §701(b)(2), redesignated par. (8) as (5). Former par. (5) redesignated (3).

Subsec. (a)(6). Pub. L. 100–607, §701(b)(2), (e), added par. (6) and redesignated former par. (6) as (4).

Subsec. (a)(7). Pub. L. 100–607, §701(b)(1), struck out par. (7) which related to demonstrating clinical nurse education programs which combine educational curricula and clinical practice in health care delivery organizations, including acute care facilities, long-term care facilities, and ambulatory care facilities.

Subsec. (a)(8). Pub. L. 100–607, §701(b)(2), redesignated par. (8) as (5).

Subsec. (a)(9). Pub. L. 100–607, §701(b)(2), struck out par. (9) which related to demonstrating methods to encourage nursing graduates to practice in health manpower shortage areas (designated under section 254e of this title) in order to improve the specialty and geographical distribution of nurses in the United States.

Subsecs. (b) to (d). Pub. L. 100–607, §701(f)–(h), added subsecs. (b) to (d) and redesignated former subsecs. (b) to (d) as (e) to (g), respectively.

Subsec. (e). Pub. L. 100–607, §721(b)(1)(A), substituted "Advisory Council on Nurses Education" for "National Advisory Council on Nurse Training".

Pub. L. 100–607, §701(f)(1), redesignated former subsec. (b) as (e).

Subsec. (f). Pub. L. 100–607, §721(b)(1)(B), substituted "Advisory Council on Nurses Education" for "National Advisory Council on Nurse Training".

Pub. L. 100–607, §701(f)(1), redesignated former subsec. (c) as (f).

Subsec. (g). Pub. L. 100–607, §701(i), amended subsec. (g) generally. Prior to amendment, subsec. (g) read as follows:

"(1) For payments under grants and contracts under paragraphs (1) through (6) of subsection (a) of this section, there are authorized to be appropriated $9,500,000 for the fiscal year ending September 30, 1986, $9,500,000 for the fiscal year ending September 30, 1987, and $9,500,000 for the fiscal year ending September 30, 1988. Of the funds appropriated under this paragraph for any fiscal year beginning after September 30, 1985, not less than 20 percent of the funds shall be obligated for payments under grants and contracts for special projects described in subsection (a)(1) of this section, not less than 20 percent of the funds shall be obligated for payments under grants and contracts for special projects described in subsection (a)(4) of this section, and not less than 10 percent of the funds shall be obligated for payments under grants and contracts for special projects described in subsection (a)(5) of this section.

"(2) For payments under grants and contracts under paragraphs (7), (8), and (9) of subsection (a) of this section, there are authorized to be appropriated $2,700,000 for the fiscal year ending September 30, 1986, $2,700,000 for the fiscal year ending September 30, 1987, and $2,700,000 for the fiscal year ending September 30, 1988. In making grants and entering into contracts with amounts appropriated under this paragraph, the Secretary shall give priority to applications for grants and contracts under paragraph (8) of subsection (a) of this section."

Pub. L. 100–607, §701(f)(1), redesignated former subsec. (d) as (g).

1985-Subsec. (a)(4), (5). Pub. L. 99–129, §227(a)(1), added par. (4) and redesignated former par. (4) as (5).

Subsec. (a)(6) to (9). Pub. L. 99–129, §227(a)(1), redesignated pars. (6) to (8) as pars. (7) to (9), respectively.

Pub. L. 99–92, §3(a), added pars. (6) to (8).

Subsec. (d)(1). Pub. L. 99–129, §227(a)(2)(A), substituted "paragraphs (1) through (6)" for "paragraphs (1) through (5)".

Pub. L. 99–92, §3(b)(1)–(3), redesignated former subsec. (d) as par. (1) and, as so designated, substituted provisions authorizing appropriations under subsec. (a)(1) to (5) for fiscal years ending Sept. 30, 1986, 1987, and 1988, for provisions authorizing appropriations under this section for fiscal year 1976 through fiscal year ending Sept. 30, 1984, and substituted "1985" for "1981", and "this paragraph" for "this subsection".

Subsec. (d)(2). Pub. L. 99–129, §227(a)(2)(B), (C), substituted "paragraphs (7), (8), and (9)" for "paragraphs (6), (7), and (8)", and "paragraph (8)" for "paragraph (7)".

Pub. L. 99–92, §3(b)(4), added par. (2).

1981-Subsec. (a). Pub. L. 97–35, §2753(a)(1), redesignated pars. (3) to (7) as (1) to (5), respectively. Former pars. (1), (2), and (8), which related to assistance leading to establishment of nurse training programs, modification or creation of new nursing programs, and assistance for costs of developing short-term in-service training programs, respectively, were struck out.

Subsec. (d). Pub. L. 97–35, §2753(b)(1), inserted provisions authorizing appropriations for fiscal years ending Sept. 30, 1982, 1983, and 1984.

Pub. L. 97–35, §2753(b)(2), substituted provisions respecting obligation of funds for fiscal years beginning after Sept. 30, 1981 for provisions respecting obligation of funds for any fiscal year.

1979-Subsec. (d). Pub. L. 96–76 authorized appropriations of $17,000,000 for fiscal year ending Sept. 30, 1980.

Effective Date of 1992 Amendment

Amendment by Pub. L. 102–531 effective immediately after enactment of Pub. L. 102–408, see section 313(c) of Pub. L. 102–531, set out as a note under section 292y of this title.

Effective Date of 1985 Amendment

Section 10 of Pub. L. 99–92 provided that:

"(a) Except as provided in subsection (b), this Act [enacting section 297i of this title, transferring section 296c to section 298b–5 of this title, amending this section, sections 296l, 296m, 297, 297–1, 297a, 297b, 297d, 297e, 298, 298b, and 298b–5 of this title, sections 1332, 1333, 1336, and 1341 of Title 15, Commerce and Trade, and section 6103 of Title 26, Internal Revenue Code, repealing sections 296 to 296b, 296d to 296f, 296j, 297h, and 297j of this title, and enacting provisions set out as notes under sections 201 and 298b–5 of this title and section 1333 of Title 15] and the amendments and repeals made by this Act shall take effect on October 1, 1985.

"(b)(1) The provisions of section 9(c) of this Act [transferring section 296c of this title to section 298b–5 of this title, amending section 298b–5 of this title, and enacting provisions set out as notes under section 298b–5 of this title] and the amendment made by paragraph (1) of such section shall take effect on the date of enactment of this Act [Aug. 16, 1985].

"(2) The amendment made by section 8(a) of this Act [amending section 297a of this title] shall take effect June 30, 1984."

Savings Provision for Current Projects

Section 202(c) of Pub. L. 102–408 provided that: "In the case of any authority for making awards of grants or contracts that is terminated by the amendment made by subsection (a) [amending this section], 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 [Oct. 13, 1992], 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."

Required Assurances Regarding Bloodborne Diseases

Secretary of Health and Human Services may make an award of a grant or contract under this subchapter for provision of traineeships only if applicant provides assurances satisfactory to Secretary that all trainees will, as appropriate, receive instruction in utilization of universal precautions and infection control procedures for prevention of transmission of bloodborne diseases, see section 308 of Pub. L. 102–408, set out as a note under section 295j of this title.

Eligibility To Receive Additional Grants

Section 2753(a)(2) of Pub. L. 97–35 provided that: "Notwithstanding the amendment made by paragraph (1) of this subsection and paragraph (2) of subsection (b) [amending this section], an entity which received a grant or contract under section 820(a) of the Public Health Service Act [subsec. (a) of this section] for the fiscal year ending September 30, 1981, for a project described in paragraph (1), (2), or (8) of such section (as in effect when it received the grant or contract) may receive one additional grant or contract under such section for such project."