By David Baime
Community College Times
September 3, 2002
Congress has responded to the severe and highly publicized nurse manpower shortage by passing, in late July, the Nurse Reinvestment Act. The legislation was signed into law by President Bush on Aug. 1. The act both creates new programs and amends existing federal nurse education programs contained in the Public Health Service Act.
The final measure was a compromise between an ambitious Senate bill and its more incremental House counterpart. However, enactment of the legislation does not mean that the work of community colleges in this area is complete — in fact, it is just beginning.
The Nurse Reinvestment Act has a number of disparate thrusts, all designed to combat the critical nursing shortage. One of the act’s prongs is to publicize the desirability of nursing careers through public service announcements. Given recent declines (albeit small ones) in enrollments in community college nursing programs, the American Association of Community Colleges (AACC) hopes that publicity will help stimulate interest in those programs.
The Reinvestment Act also includes new incentives for individuals to pursue nursing careers. Most importantly, new “National Health Service Corps” scholarships for nursing students would cover the cost of their education, in exchange for recipient’s agreeing to practice for at least two years in facilities that have a critical shortage of nurses. Given the propensity of community college graduates to practice in underserved, particularly rural, areas, this new provision could provide an effective means of helping community college nursing students finance their education.
The legislation also renames and makes a number of changes to the former Basic Nurse Education and Practice Program (BNEP), now called Nurse Education, Practice, and Retention (NEPR) Grants. Currently, not a single community college is receiving a BNEP grant, even though the program receives a $16.3 million appropriation and community colleges are eligible for funding, at least on paper. The lack of participation by community colleges in BNEP reflects negatively on the interest and/or ability of the Department of Health and Human Services (and its Bureau of Health Professions) to support the programs that educate very close to 50 percent of all new registered nurses. AACC looks forward to actively engaging DHHS in structuring the new grant program so that community colleges can effectively access these funds.
Community college advocates were not pleased that the final conference version of the NEPR program includes a new purpose for which funds may be used in “expanding the enrollment in baccalaureate nursing programs.” This particular language was not contained in either the House- or Senate-passed bills that were taken to conference. The exclusion of community college and other AD nursing programs from this new provision is typical of the advocacy handiwork of four-year colleges of nursing.
Given the professed interest of the Washington, D.C., representatives of BSN programs in working collaboratively with AACC to make nursing programs more attractive to all aspiring students, this turn of events was disappointing. But, much more importantly, this outcome is poor public policy; indeed, it is almost unfathomable given the pressing shortage of nurses in this country and the role that community colleges play in educating them.
The good news is that the language that relates to expanding capacity at baccalaureate programs is but one of numerous purposes for which funds can be spent in the NEPR program. Most of the other purposes clearly apply to community college nursing programs, meaning that community colleges are in no way ineligible for this important program. However, AACC will need to closely monitor the implementation of this altered program to ensure that it represents a de facto, not just de jure, inclusion of community college programs. At this point in time, it is not clear whether the Department of Health and Human Services will implement this program for the fiscal year that begins Oct. 1 or the following year.
Additional work also needs to be done to on securing funding for these and other components of the Nurse Reinvestment Act. The Senate Appropriations Committee has approved a $2 million increase for the BNEP over last year’s level.
Although this new law cannot be expected to solve the nation’s nursing shortage outright, or provide a massive new infusion of funds to community college programs, it does represent a significant policy development. AACC intends to make sure that community colleges are able to capitalize on that.
David Baime is vice president of government relations at AACC.