NLN's Footsteps Heard on the "Hill"|
Board of Governors Advocates for Title VII and VIII Funding
The NLN Board of Governors took to Capitol Hill on May 25. During the meetings with their congressional delegations, board members advocated for increased funding for Title VIII — Nursing Workforce Development Programs and for the Health Professions Programs under Title VII of the Public Health Service Act.
Armed with data, the board members took on the role of nurse advocates. In their visits, they noted that:
Title VIII - Nursing Workforce Development Programs
Title VII - Health Professions Programs
- The NLN supports a budget of $313.075 million in FY 2012 for the Nursing Workforce Development Programs and $20 million for Nurse-Managed Health Clinics (NMHC).
- Our health care system is integral to the US economy. With a spending level of $2.5 trillion in 2009, it constitutes the largest share of the nation's gross domestic product (GDP), growing from 8.8 percent of GDP in 1980 to 17.6 percent of GDP in 2009. It is virtually the only sector that added jobs to the economy on a net basis since 2001.
- With more than 3.78 million active, licensed RNs in 2009, nurses represent the largest occupation of all health care workers in the United States and provide 85 percent of the health care delivery.
- The Bureau of Labor Statistics reports that employment of RNs is expected to grow 22 percent from 2008 to 2018, much faster than the average for all occupations. During this time, the system is projected to generate 581,500 new RN jobs.
- The Health Resources and Services Administration (HRSA) projects that, absent aggressive intervention, the RN workforce will fall 36 percent below requirements by 2020.
- The present nurse faculty staffing deficit is expected to intensify as the existing nurse educator workforce reaches retirement age, with 48 percent of nurse faculty over the age of 55, fully one half of today's nurse faculty workforce is expected to retire by 2015, while more than one in five (21 percent) expects to retire within the next five years.
Nurse-Managed Health Clinics
- The NLN is supporting an FY 2012 budget of at least $449.454 million for Title VII — Health Professions Programs. This request will provide critical support for the education of health care providers. It fills the gaps in the workforce not met by traditional market forces, such as the gap in health coverage where almost 20 percent of the nation's population lives in government-designated rural and urban Health Professional Shortage Areas (HPSA).
- Destabilizing funding for the Title VII programs would reduce education and training support for primary care physicians, nurses, and other health professionals, exacerbating shortages and further straining the nation's already fragile health care system.
- A report by the Institute of Medicine characterized the HRSA health professions programs as an "undervalued asset" and recommended that Congress "invest in programs with proven effectiveness."
- High quality accessible primary care improves health care outcomes and reduces costs, with improved satisfaction for both recipients and providers of the care. As of May 4, 2011, there are 6,413 Primary Care HPSAs with 66 million people living in them. It would take 17,588 practitioners to meet their need for primary care providers (a population to practitioner ratio of 2,000:1). Title VII programs are a cost-effective source of federal funding for the education of health care providers who are more likely to return to medically underserved areas where shortages occur.
- According to a National Conference of State Legislatures survey, federal funding of Title VII programs influences the allocation of funds from the states and other sources to these programs, which are viewed as fundamental to the states' health care workforce goals.
- There are only 7,590 geriatricians in the US — one for every 2,500 seniors; by 2030, there will be only one for every 4,254. Since inception, the Title VII Geriatric Education Program has trained more than 425,000 health practitioners in more than 27 health disciplines.
- An existing shortage of primary care providers exists will continue to grow over the next decade. With the recent growth of NMHCs, APRNs have demonstrated their flexibility as they practice in both primary care and specialty areas. This shift suggests that professionals' practice can be directed to changing workforce and population needs as the increased use of APRNs holds the potential for improving access, reducing costs for high-value care, and changing patterns of care.
- NMHCs deliver comprehensive primary health care services, disease prevention, and health promotion in medically underserved areas for vulnerable populations. Approximately 58 percent of NMHC patients are either uninsured, Medicaid recipients, or self-pay.
FROM THE STATES . . .
Missouri Law Provides Grants for the Hiring of Nursing Faculty
On June 16, Missouri Governor Jay Nixon (D) signed into law, HB 223, the Advanced Placement Incentive Grant Program for STEM and Caring for Missourians Nursing Education Incentive. In part, the new law will help meet Missouri's need for more nurses by providing the state's colleges and universities with grants to enable the hiring of additional faculty to train more nurses. The law also will provide more scholarships to Missouri students who pursue college degrees in math and science.
Funding for Texas Nursing Programs Maintained
Nixon said that the section of the law adding resources so Missouri's colleges and universities can produce more nurses is critical. "Missouri needs more nurses, and this bill will help meet that demand." The measure creates grants up to $150,000 per year, per campus, to higher education institutions to hire nursing faculty to address areas of need. The grants will be funded by dollars generated through nursing licensure fees. The State Board of Nursing and the Department of Higher Education will determine categories and criteria for the grants.
While the University of Texas at Arlington (UTA) appears to have maintained funding for its nursing programs, it does stand to lose $10.2 million in state funding over the next two years. Nevertheless, the funding picture for UTA, the University of North Texas (UNT), and other universities in the state is not as bad as expected.
As for its nursing programs, UTA will likely get the $5 million it requested to continue offering programs through its Regional Nursing Education Center. UTA spokesperson Kristin Sullivan said, "Our hope is that it will continue to enable the College of Nursing to expand student capacity." Sullivan explained that, as the program continues to draw students, it must invest in technology and professors. The program had 6,600 students during the spring semester.
Senator Chris Harris (R-Arlington) and Representative Diane Patrick (R-Arlington) said that, despite the need for dramatic cuts in higher education, they pushed to maintain funding for the center, which includes on-campus and online nursing classes. "Although this has been a challenging budget session, due to the estimated $27 billion shortfall, we allocated available resources to the state's most critical areas: nursing shortage and student aid," Patrick said.