Public Health Nursing Act
- Sponsor
- Rep. Stansbury, Melanie A. [D-NM-1]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- Jan 8, 2026
Bottom line
The bill establishes a significant federal grant program to bolster the public health nursing workforce, targeting underserved communities and authorizing $50 billion over ten years.
What it actually does
This bill amends the Public Health Service Act to mandate that the Secretary of Health and Human Services establish, expand, and sustain a public health nursing workforce. It authorizes $5 billion annually for ten fiscal years (2026-2035) for grants to State, local, and territorial public health departments to recruit, hire, and train licensed registered nurses, particularly in medically underserved areas, and to cover related costs like medical supplies. The bill prioritizes applicants serving vulnerable populations and those with collective bargaining agreements or non-interference policies regarding employee rights.
Proponents argue
Supporters argue that this legislation is a critical investment in the nation's public health infrastructure, addressing long-standing workforce shortages and enhancing preparedness for future health crises. They contend that expanding the public health nursing workforce, especially in vulnerable communities, will improve health outcomes, reduce disparities in chronic disease, infant mortality, and maternal morbidity, and ensure equitable access to essential health services.
Opponents contend
Critics might raise concerns about the substantial federal spending authorized by the bill, questioning its long-term fiscal sustainability and potential impact on the national debt. Some may also argue that the inclusion of collective bargaining agreements as a grant priority introduces non-health-related criteria that could unduly influence local labor practices or disadvantage departments that do not have such agreements, regardless of their public health needs.
The bill is short and clearly written, making it highly accessible for an informed reader to evaluate its provisions quickly.
Section 2, amending Part E of title VII of the Public Health Service Act, adding Subpart 4, Section 780(a).
Establishment of Public Health Nursing Workforce Activities and Grants
This provision mandates the Secretary of Health and Human Services (HHS) to initiate and support activities aimed at creating, growing, and maintaining a robust public health nursing workforce. The primary mechanism for achieving this is through providing grants to State, local, and territorial public health departments, thereby establishing the core federal program.
Supporters argue
Supporters argue this provision directly addresses critical shortages in the public health nursing sector, enabling states and localities to build robust workforces essential for community health and emergency preparedness.
Critics contend
Critics might argue that while the goal is laudable, a broad federal mandate and grant program could lead to inefficiencies or a one-size-fits-all approach that doesn't adequately account for diverse local needs.
Tradeoffs
This provision balances the need for a strong national public health infrastructure with the principle of local control over healthcare delivery and workforce management.
Section 2, amending Part E of title VII of the Public Health Service Act, adding Subpart 4, Section 780(b).
Permissible Uses of Grant Funds
This section details how grant funds can be utilized by public health departments. Funds are primarily for covering costs, including wages and benefits, associated with recruiting, hiring, and training licensed registered nurses to serve as public health nurses. These nurses are expected to work for the departments, especially in medically underserved areas, in various public health facilities, or provide home visitation. Additionally, funds can be used for necessary medical supplies, including personal protective equipment, and administrative costs. The provision also allows for subgrants to local health departments.
Section 2, amending Part E of title VII of the Public Health Service Act, adding Subpart 4, Section 780(c).
Priority Criteria for Grant Selection
When selecting grant recipients, the Secretary is directed to give priority to applicants that propose to serve specific vulnerable populations, including those with high rates of chronic disease, infant mortality, or maternal morbidity and mortality; low-income populations (including medically underserved areas); populations in health professional shortage areas; maternity care health professional target areas; or rural/traditionally underserved populations. Additional priority is given to applicants demonstrating a plan for culturally and linguistically appropriate services and those with documented collective bargaining agreements or explicit policies not to interfere with employee rights under the National Labor Relations Act.
Section 2, amending Part E of title VII of the Public Health Service Act, adding Subpart 4, Section 780(d).
Maintenance of Effort Requirement
This provision requires any recipient of a grant under this program to maintain their non-Federal expenditures for public health nursing activities at a level that is not less than the amount spent in the fiscal year preceding the grant. This is designed to prevent states and localities from reducing their own funding for public health nursing and using federal funds to supplant existing investments.
Section 2, amending Part E of title VII of the Public Health Service Act, adding Subpart 4, Section 780(f).
Authorization of Appropriations
This provision authorizes the appropriation of $5,000,000,000 (five billion dollars) to the Secretary of Health and Human Services for each of fiscal years 2026 through 2035. This provides the legislative authority for the federal government to allocate significant financial resources to carry out the public health nursing workforce activities outlined in the bill over a ten-year period.
The bill prioritizes grant applicants serving 'medically underserved populations (as defined in section 330(b))', 'health professional shortage areas (as defined in section 332(a))', and 'maternity care health professional target areas identified under section 332(k)'.
Section 2, amending Part E of title VII of the Public Health Service Act, adding Subpart 4, Section 780(c)(1)(B), (C), (D).
Why it matters:This is standard legislative drafting practice to avoid reprinting lengthy definitions and ensure consistency with existing law and federal designations, rather than an attempt to obscure the provision.
Case for: Supporters argue that using established definitions ensures that federal resources are consistently directed to areas already identified by federal health agencies as having critical needs, leveraging existing data and frameworks for efficiency and targeted impact.
Case against: Critics might suggest that relying on external definitions, which can be complex and subject to change, makes the bill less transparent and harder for the public to understand precisely which areas will benefit from the prioritization.
Estimated impact: This provision directs a significant portion of the $50 billion authorized funding to specific, federally designated high-need areas across the country, ensuring resources are concentrated where health disparities are most pronounced.