"(2) The remainder of such balance shall be paid to the school. "(b) After September 30, 1972, each school with which the Secretary has made an agreement under this part shall pay to the Secretary, not less often than quarterly, the same proportionate share of amounts received by the school after June 30, 1972, in payment of principal or interest on loans made from the loan fund established pursuant to such agreement as was determined for the Secretary under subsection (a). "LOANS TO SCHOOLS "SEC. 828.( a) Upon application by any school with which he has made an agreement under this part, the Secretary may make a loan to such school for the purpose of helping to finance deposits required by section 823(b)(2) (B) in a loan fund established pursuant to such agreement. Such loan may be made only if the school shows it is unable to secure such funds upon reasonable terms and conditions from non-Federal sources. Loans made under this section shall bear interest at a rate sufficient to cover (1) the cost of the funds to the Treasury, (2) the cost of administering this section, and (3) probable losses. "(b) There are authorized to be appropriated such sums as may be necessary to carry out this section. "(c) Loans by the Secretary under this section shall mature within such period as the Secretary determines to be appropriate in each case, but not exceeding fifteen years. "ADMINISTRATIVE PROVISIONS "SEC. 829. The Secretary may agree to modifications of agreements or loans made under this part, and may compromise, waive, or release any right, title, claim, or demand of the United States arising or acquired under this part. "PART C-GENERAL "NATIONAL ADVISORY COUNCIL ON NURSES TRAINING; REVIEW COMMITTEE "SEC. 841. (a) (1) There is hereby established a National Advisory Council on Nurse Training, consisting of the Surgeon General, who shall be Chairman, and the Commissioner of Education, both of whom shall be ex officio members, and sixteen members appointed by the Secretary without regard to the civil service laws. Four of the appointed members shall be selected from the general public and twelve shall be selected from among leading authorities in the various fields of nursing, higher, and secondary education, and from representatives of hospitals and other institutions and organizations which provide nursing services. "(2) The Council shall advise the Surgeon General in the preparation of general regulations and with respect to policy matters arising in the administration of this title, and in the review of applications for construction projects under part A and of applications under section 806. "(b) The Secretary of Health, Education, and Welfare shall, prior to July 1, 1967, and without regard to the civil service laws, appoint a committee, consisting of members of the public, of various groups particularly interested in or expert in matters relating to education of various types of nurses, for the purpose of reviewing the programs authorized by this title and making recommendations with respect to continuation, extension, and modification of any of such programs. A report of the findings and recommendations of such committee shall be submitted to the Secretary not later than November 1, 1967, after which date such committee shall cease to exist. The Secretary shall submit such report, together with his comments and recommendations thereon, to the Congress on or before January 1, 1968. "(c) Appointed members of the Council or the review committee who are not regular full-time employees of the United States shall, while attending conferences or meetings thereof, be entitled to receive compensation at a rate to be fixed by the Secretary but not exceeding $75 per diem, including travel time, and while away from their homes or regular places of business they may be allowed travel expenses, including per diem in lieu of subsistence, as authorized by section 5 of the Administrative Expenses Act of 1946 (5 U.S.C. 73b-2) for persons in the Government service employed intermittently. 31-912-64- -2 "NONINTERFERENCE WITH ADMINISTRATION OF INSTITUTIONS "SEC. 842. Nothing contained in this title shall be construed as authorizing any department, agency, officer, or employee of the United States to exercise any direction, supervision, or control over, or impose any requirement or condition with respect to, the personnel, curriculur, methods of instruction, or administration of any institution. "DEFINITIONS "SEC. 843. For purposes of this title "(a) The term 'State' means a State, the Commonwealth of Puerto Rico, the District of Columbia, the Canal Zone, Guam, American Samoa, or the Virgin Islands. "(b) The term 'school of nursing' means a collegiate, associate degree, or diploma school of nursing. "(e) The term 'collegiate school of nursing' means a department, division, or other administrative unit in a college or university which provides primarily or exclusively an accredited program of education in professional nursing and allied subjects leading to the degree of bachelor of arts, bachelor of science, bachelor of nursing, or to an equivalent degree, or to a graduate degree in nursing. "(d) The term 'associate degree school of nursing' means a department, division, or other administrative unit in a junior college, community college, college, or university which provides primarily or exclusively an accredited two-year program of education in professional nursing and allied subjects leading to an associate degree in nursing or to an equivalent degree. "(e) The term 'diploma school of nursing' means a school affiliated with a hospital or university, or an independent school, which provides primarily or exclusively an accredited program of education in professional nursing and allied subjects leading to a diploma or to equivalent indicia that such program has been satisfactorily completed. "(f) The term 'accredited' when applied to any program of nurse education means a program accredited by a recognized body or bodies approved for such purpose by the Commissioner of Education, except that a program which is not, at the time of the application under this title by the school which provides or will provide such program, eligible for accreditation by such a recognized body or bodies, shall be deemed accredited for purposes of this title in the following cases if the Commissioner of Education finds, after consultation with the appropriate accreditation body or bodies, that there is reasonable assurance that the program will meet the accreditation standards of such body or bodies (1) in the case of an applicant under part A for a grant for a project for construetion of a new school, prior to or upon completion of the facility with respect to which the application is filed; (2) in the case of a school applying for a grant under section 806, prior to or upon completion of the project with respect to which the application is filed; and (3) in the case of a school seeking an agree ment under part B for establishment of a student loan fund, prior to the beginning of the academic year following the normal graduation date of students who are in their first year of instruction at such school during the fiscal year in which the agreement with such school is made under part B; except that the provisions of this clause (3) shall not apply for purposes of section 826. "(g) The term 'nonprofit' as applied to any school, agency, organization, or institution means one which is a corporation or association, or is owned and operated by one or more corporations or associations, no part of the net earnings of which inures, or may lawfully inure, to the benefit of any private shareholder or individual. "(h) The term 'secondary school' means a school which provides secondary education, as determined under State law except that it does not include any education provided beyond grade 12. "(i) The term 'construction' and 'cost of construction' include (1) the construction of new buildings, and the acquisition, expansion, remodeling, replacement, and alteration of existing buildings, including architects' fees, but not including the cost of acquisition of land (except in the case of acquisition of an existing building), off-site improvements, living quarters, or patient-care facilities, and (2) equipping new buildings and existing buildings, whether or not acquired, expanded, remodeled, or altered." SEC. 3. (a) Effective with respect to appropriations for fiscal years beginning after June 30, 1964, section 720 of the Public Health Service Act is amended by striking out "nurses," wherever it appears therein. (b) Effective with respect to applications for grants from appropriations for fiscal years beginning after June 30, 1964, subsections (b), (c), and (d) of section 721 of such Act are amended by striking out "nursing," wherever it appears therein, and section 631 (e) of such Act is amended by striking out "nurses' home and training facilities" and inserting in lieu thereof “nurses' home facilities". (c) Effective with respect to appointments to the National Advisory Council on Education for Health Professions made after enactment of this Act, section 725 (a) of such Act is amended by striking out "nursing,". (d) Effective July 1, 1964, section 728 of such Act is amended by striking out "nursing,". SEC. 4. (a) Section 1 of the Public Health Service Act is amended to read as follows: "SECTION 1. Titles I to VIII, inclusive, of this Act may be cited as the 'Public Health Service Act'." (b) The Act of July 1, 1944 (58 Stat. 682), as amended, is further amended by renumbering title VIII (as in effect prior to the enactment of this Act) as title IX, and by renumbering sections 801 through 814 (as in effect prior to the enactment of this Act), and references thereto, as sections 901 through 914, respectively. EXECUTIVE OFFICE OF THE PRESIDENT, BUREAU OF THE BUDGET, Washington, D.C., April 10, 1964. Hon. OREN HARRIS, Chairman, Committee on Interstate and Foreign Commerce, House of Representatives, Longworth House Office Building, DEAR MR. CHAIRMAN: This is in reply to your request for the views of the Bureau of the Budget on H.R. 10042, a bill to amend the Public Health Service Act to increase the opportunities for training professional nursing personnel, and for other purposes. As stated by the President in his health message, the growing complexity of medical science requires an increasing number of trained medical practitioners to meet the present acute shortage of manpower in this area. The enactment of the Health Professions Educational Assistance Act of 1963 was an important step in the Federal effort to encourage medical education. This effort requires further supplementation to increase the number of nurses required for modern medical care. Nursing school enrollments must be raised by 75 percent to train the professional nurses which we need. This bill incorporates those elements enumerated by the President which will not only increase the quantity of nurses trained but also increase the quality of that training. Enactment of this legislation would be in accord with the program of the President. Sincerely yours, PHILLIP S. HUGHES, Assistant Director for Legislative Reference. U.S. CIVIL SERVICE COMMISSION, Hon. OREN HARRIS, Chairman, Committee on Interstate and Foreign Commerce, House of Representatives, Longworth House Office Building, Washington, D.C. DEAR MR. CHAIRMAN: This is in further reply to your request of February 27, 1964, for the views of the Civil Service Commission on H.R. 10042, a bill to amend the Public Health Service Act to increase the opportunities for training professional nursing personnel, and for other purposes. Section 2 of the bill would add a new title VIII to the Public Health Service Act. Our comments are limited to the personnel provisions contained in section 841 of title VIII. Section 841 (a) (1) would establish a National Advisory Council on Nurse Training, consisting of the Surgeon General, the Commissioner of Education, and 16 members appointed by the Secretary of Health, Education, and Welfare. Subsection (b) would authorize the Secretary to appoint a committee to review and make subsequent recommendations on the programs authorized by this title. The 16 members of the Council and the members of the committee would be appointed without regard to civil service laws. Subsection (c) provides that Council and committee members who are not regular and full-time employees of the Federal Government would receive compensation not exceeding $75 per diem while attending conferences and meetings of the committee. The would also receive travel expenses, including per diem in lieu of subsistence customarily authorized for persons employed intermittently in the Government service. We have no objections to these provisions. The Bureau of the Budget advises that from the standpoint of the administration's program there is no objection to the submission of this report. By direction of the Commission: Sincerely yours, JOHN W. MACY, Jr., Chairman. Hon. OREN HARRIS, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, Chairman, Committee on Interstate and Foreign Commerce, DEAR MR. CHAIRMAN: This letter is in response to your request of February 27, 1964, for a report on H.R. 10042, the proposed Nurse Training Act of 1964. This bill embodies a legislative proposal submitted to the Congress by this Department on February 10 to carry out the purposes of improvement of nursing services proposed by President Kennedy and President Johnson in their health messages. There are enclosed herewith for the committee's convenience a copy of our letter to the Speaker submitting the bill, a copy of a detailed section-by-section analysis of the bill, and a copy of the cost estimates that were enclosed with the letter to the Speaker. For the reasons set forth in the Presidential messages referred to and in our letter to the Speaker, we urge enactment of this bill. Sincerely, Enclosures. ANTHONY J. CELEBREZZE, Secretary. Washington, February 10, 1964. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, Hon. JOHN W. McCORMACK, DEAR MR. SPEAKER: I am enclosing for your consideration a draft of a bill to increase the number and improve the training of professional nurses and other nursing personnel, and to improve nursing service. This bill would carry out the purposes of improvement of nursing services proposed by President Kennedy in his three special health messages to the Congress and by President Johnson in his 1964 health message. The proposed program is based on the recommendations of the Surgeon General's Consultant Group on Nursing who, in their report of February 1963, pointed out that our Nation faces a critical problem in insuring adequate nursing services in the years ahead. The Consultant Group pointed out that past and existing Federal programs have demonstrated "how effective Federal assistance can be in increasing the supply of nurses when the action is soundly conceived and boldly taken. What is required to meet our pressing needs for adequate nursing care is a broad and integrated attack on the many problems in the nursing field." The proposed Nurse Training Act of 1964 would amend the Public Health Service Act by adding a new title VIII-"Nurse Training." This title would (1) authorize a new 4-year program of construction grants for teaching facilities to expand the training capacity of nursing schools; (2) provide financial assistance to students of nursing; (3) provide grants for area, State, interstate, and regional planning for the development and improvement of nursing education and services; and (4) provide grants for developing new or improved methods of training and of recruiting students and for improving the utilization of nursing personnel. PART A. GRANTS FOR EXPANSION AND IMPROVEMENT OF NURSE TRAINING Construction grants To help meet the urgent need for facilities to expand the Nation's capacity to train nurses, part A of the new title VIII would authorize a 4-year program of construction grants to accredited public or nonprofit private schools of nursing to assist in the construction of teaching facilities. This authorization would parallel the provisions of Public Law 88-129, the recently enacted Health Professions Educational Assistance Act of 1963. Eligible for grants would be schools providing collegiate, diploma, or associate degree programs. Grants would aid construction of new schools, construction which would expand substantially the training capacity of an existing school, or replacement or rehabilitation of facilities which are so obsolete as to require the school to curtail substantially either its enrollment or the quality of training provided. In considering grant applications, the Surgeon General would take into account effectiveness in expanding and maintaining enrollment, and in promoting an equitable geographic distribution of opportunities for such training. Funds for construction would be authorized on a matching basis beginning in fiscal year 1966. Grants for construction of collegiate schools would be limited by a ceiling of $5 million the first year and $10 million in each of the following 3 years. Collegiate schools of nursing would no longer be eligible for funds under the provisions of Public Law 88-129. Grants for construction of hospital and associate degree schools would be limited to $15 million the first year, and $20 million in each of the 3 succeeding years. The Federal share of construction costs in the case of new schools or major expansion of existing schools could be up to 66% percent of necessary costs of construction. Other grants under this authorization could not exceed 50 percent of construction costs. The sums of money proposed for construction would enable the schools to expand their annual admissions by the end of the 4-year period by an estimated 23,000 students. Improvement in nurse training and services A new program of project grants to public or nonprofit private agencies, organizations, and institutions would be authorized to develop new or improved methods of training nurses or recruiting persons to undergo such training. These grants would also be made to develop new or improved ways of providing better services with existing nursing personnel. Project grants could not exceed 5 years' duration. Project grants would be available for schools to strengthen, improve, or expand their programs. Accredited schools of nursing would be eligible, as would other schools if there were reasonable assurance that the program would meet accreditation standards upon completion of the project. The authorization for project grants would be $3.8 million for fiscal year 1965, increasing to $15 million in fiscal year 1969. Planning grants Part A of the new title VIII would also authorize $4.4 million for 2 years for matching grants to State, interstate, regional, or local area agencies to assist them in surveying their present and future needs for nurses and in planning for the development of educational facilities, personnel, and programs required to meet their needs. It is anticipated that these planning groups would play a major role in encouraging educational and service agencies and institutions to undertake appropriate action to increase school capacity and enrollment, improve educational programs and faculty, and improve the effectiveness of nursing service through the most efficient utilization of nursing personnel. These planning groups would also provide information to the Surgeon General on the relative merits of applications under this bill in achieving the goals of the area, State, or regional plans. State, interstate, regional, or local area groups would be eligible to apply for these funds, and would be required to provide not less than 33% percent of the cost of the planning. |