S.Amdt. 2798

SA 2798. Mr. INOUYE submitted an amendment intended to be proposed to
amendment SA 2786 proposed by Mr. Reid (for himself, Mr. Baucus, Mr.
Dodd, and Mr. Harkin) to the bill H.R. 3590, to amend the Internal
Revenue Code of 1986 to modify the first-time homebuyers credit in the
case of members of the Armed Forces and certain other Federal
employees, and for other purposes; which was ordered to lie on the
table; as follows:

At the end of subtitle D of title V, add the following:

SEC. 5316. DEMONSTRATION GRANTS FOR FAMILY NURSE PRACTITIONER
TRAINING PROGRAMS.

(a) Establishment of Program.--The Secretary of Health and
Human Services (referred to in this section as the
``Secretary'') shall establish a training demonstration
program for family nurse practitioners (referred to in this
section as the ``program'') to employ and provide intensive,
one-year training for nurse practitioners who have graduated
from a nurse practitioner program not more than 18 months
prior to commencing such training, for careers as primary
care providers in Federally qualified health centers
(referred to in this section as ``FQHCs'') and nurse-managed
health clinics, in order to increase access to primary care
in impoverished, urban, and rural underserved communities.
(b) Purpose.--The purpose of the program is to enable each
grant recipient to--
(1) provide new nurse practitioners with a depth, breadth,
volume, and intensity of clinical training necessary to serve
as primary care providers in the complex settings of FQHCs
and nurse-managed health clinics;
(2) train new nurse practitioners to work under a model of
primary care, including the use of electronic health records,
planned care and chronic care models, and interdisciplinary
team-based care, that is consistent with--
(A) the principles of health care set forth by the
Institute of Medicine; and
(B) the needs of vulnerable populations;
(3) create a model of FQHC- and nurse-managed health
clinic-based training for nurse practitioners that may be
replicated nationwide; and
(4) provide additional intensive learning experiences with
high-volume, high-risk, or high-burden problems commonly
encountered in FQHCs and nurse-managed health clinics, such
as HIV/AIDS, prenatal care, orthopedics, geriatrics,
diabetes, asthma, and obesity prevention.
(c) Grants.--The Secretary shall award grants to eligible
entities that meet the eligibility requirements established
by the Secretary, for the purpose of operating the nurse
practitioner primary care programs described in subsection
(a) in such entities.
(d) Eligible Entities.--To be eligible to receive a grant
under this section, an entity shall--
(1)(A) be a FQHC as defined in section 1861(aa) of the
Social Security Act (42 U.S.C. 1395x(aa)); or
(B) be a nurse-managed health clinic, as defined in section
330A-1 of the Public Health Service Act (as added by section
5208 of this Act); and
(2) submit to the Secretary an application at such time, in
such manner, and containing such information as the Secretary
may require.
(e) Priority in Awarding Grants.--In awarding grants under
this section, the Secretary shall give priority to eligible
entities that--
(1) demonstrate sufficient infrastructure in size, scope,
and capacity to undertake the requisite training of a minimum
of 3 nurse practitioners per year and the half-time
employment of a qualified program coordinator;
(2) will provide that each such program will entail 12-full
months of full-time, paid employment for each awardee, and
will offer each awardee benefits consistent with the benefits
offered to other full-time employees of such entity;
(3) will assign not less than 1 staff nurse practitioner or
physician to each of 4 precepted clinics, in which the
awardee is the primary provider for the patient, per week,
and during such clinics, ensure that the assigned staff nurse
practitioner or physician shall be available exclusively to
the awardees and have no other assigned clinical or
administrative duties;
(4) will provide to each awardee specialty rotations
consisting of 3 sessions per week, either within or outside
of the FQHC or nurse-managed health clinic, based upon the
capability of the FQHC or nurse-managed health clinic to
provide specialty training in prenatal care and women's
health, adult and child psychiatry, orthopedics, geriatrics,
and at least 3 other high-volume, high-burden specialty
areas, such as HIV/AIDS, dermatology, cardiology, diabetes,
asthma, urgent care (minor trauma), and pain management;
(5) enable awardees to practice alongside other primary
care providers so that the awardees may consult with such
primary care providers as necessary;
(6) provide educational and didactic sessions on high-
volume, high-risk health problems;
(7) have implemented (or will complete, not later than the
beginning of the program, implementation of) health
information technology, and will make use of an electronic
training evaluation system;
(8) provide continuous training to a FQHC standard of a
high performance health system that includes access to health
care, continuity, planned care, team-based, prevention-
focused care that includes the use of electronic health
records and other health information technology;
(9) have a record of recruiting, training, caring for, and
otherwise demonstrating competency in advancing the primary
care of individuals who are from underrepresented minority
groups or from a poor urban or rural, or otherwise
disadvantaged background;
(10) have a record of training health care professionals in
the care of vulnerable populations such as children, older
adults, homeless individuals, victims of abuse or trauma,
individuals with mental health or substance-related
disorders, individuals with HIV/AIDS, and individuals with
disabilities; and
(11) have a record of collaboration with other safety net
providers, schools, colleges, and universities that provide
health professions training, establish formal relationships,
and submit joint applications with rural health clinics, area
health education centers, and community health centers
located in underserved areas, or that serve underserved
populations.
(f) Eligibility of Awardees.--
(1) In general.--To be eligible for acceptance to a nurse
practitioner training program funded through a grant awarded
under this section, an individual shall--
(A) be licensed or eligible for licensure in the State in
which the program is located as an advanced practice
registered nurse or advanced practice nurse and be eligible
or board-certified as a family nurse practitioner; and
(B) demonstrate commitment to a career as a primary care
provider in a FQHC or in a nurse-managed health clinic.
(2) Preference.--In selecting awardees under the program,
each recipient of a grant under this section shall give
preference to bilingual candidates that meet the requirements
described in paragraph (1).
(3) Deferral of certain service.--The starting date of
required service of individuals in the National Health
Service Corps Service program under title II of the Public
Health Service Act (42 U.S.C. 202 et seq.) who receive
training under this section shall be deferred until the date
that is 90 days after the completion of the program.
(4) Awardee defined.--In this section, the term ``awardee''
means an individual who has been accepted into a nurse
practitioner training program funded through a grant awarded
under this section.
(g) Duration of Awards.--Each grant awarded under this
section shall be for a period of 3 years. A grant recipient
may carry over funds from one fiscal year to another without
obtaining approval from the Secretary.
(h) Grant Amount.--Each grant awarded under this section
shall be in an amount not to exceed $600,000 per year, as
determined by the Secretary, taking into account--
(1) the financial need of the FQHC or nurse-managed health
clinic, considering, Federal, State, local, and other
operational

[[Page S12165]]

funding provided to the FQHC or nurse-managed health clinic;
and
(2) other factors, as the Secretary determines appropriate.
(i) Technical Assistance Grants.--The Secretary may award
technical assistance grants to FQHCs and nurse-managed health
clinics that plan to establish, or that have established, a
nurse practitioner residency training program. The Secretary
shall award a technical assistance grant to 1 FQHC that has
expertise in establishing a nurse practitioner residency
program, for the purpose of providing technical assistance to
other recipients of grants under this section.
(j) Authorization of Appropriations.--To carry out this
section, there is authorized to be appropriated such sums as
may be necessary for each of fiscal years 2011 through 2014.
______