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 Legislation & Policy Information 

What can Congress, state legislatures, hospitals and other health care providers do to rapidly and cost-effectively reduce shortages of health-care workers and ensure patient safety?

Congress:

  • Direct a more proportionate share of federal support to nursing and allied health programs at community colleges. Community colleges educate the majority of health-care professionals and nurses more efficiently and cost-effectively (at an annual average cost of $2,272 versus $5,836 for four-year programs at public colleges), yet they receive only a fraction of the funding awarded to nursing programs. In FY 2006, community colleges received only 6% of almost $106 million in grant money awarded to schools.
  • Make community colleges eligible for participation in both existing and new federally funded programs to address the nursing shortage. Only bachelor’s degree nursing programs are eligible for grants from the current federally funded Nurse Education, Practice and Retention program for the purpose of expanding enrollments.
  • Address the nursing faculty shortage with an RN to MSN faculty scholarship that enables associate degree RNs to achieve master’s level nursing education, which credentials them to teach. The nursing faculty shortage would be significantly eased through creation of a program that directed just a fraction of the 21% of associate degree RNs who elect to obtain second undergraduate (bachelor’s) degrees to the nation’s 163 RN to MSN—registered nurse to master’s in science of nursing—programs. In exchange for RN to MSN scholarship funding, program recipients would commit to teach upon graduation.
  • Request and fund an Institute of Medicine study to determine how best to ensure an adequate nursing workforce to protect patient safety. All nursing education programs would benefit from research to discover how best to build capacity to educate RNs and enhance programs to improve the recruitment, preparation, and retention of future generations of nurses.
  • Enact the Allied Health Reinvestment Act. Educational institutions and students must have federal resources similar to those supporting nursing education (i.e., scholarships and loan programs for students and faculty) to overcome faculty shortages and other barriers to providing the nation with the allied health professionals it needs.
  • Increase funding for the Public Health Service Act, Title VII. In 2006, Congress appropriated 37 times more funding to nursing ($149.7 million) than to allied health ($4.0 million) education. Allied health funding fell by two thirds from 2005 to 2006 ($11.8 million $4.0 million), while total Title VII funding fell by just over one half, from $299.6 million to $145.2 million.
  • Reinstitute a Division of Allied Health Professions at the Health Resources and Services Administration. Make allied health programs a greater priority and more visible within the federal bureaucracy to facilitate greater awareness about the nation’s allied health shortages, opportunities, and funding needs. (The administration’s FY 2006 and FY 2007 budget requests included no funding for the allied health professions, resulting in a 51% drop in funding for both years.)

State legislatures:

  • Ensure that state regulations and laws recognize the single scope of practice that exists for all RNs. For more than 50 years, associate degree RNs have demonstrated their value as well-educated professional nurses by passing the RN licensure exam at the same or a better rate than have their bachelor’s-degree counterparts and by ably demonstrating the same professional competencies.
  • Provide state funding to community colleges to increase the number of graduates by expanding health program capacity and reducing attrition rates. State support constitutes a significantly higher percentage of community college budgets than it does the budgets of four-year institutions. Community colleges are turning qualified students away from health professions programs, a trend likely to continue as tuitions increase at four-year institutions, shortages of faculty grow, and the nation’s demand increases.
  • Address the nursing faculty shortage with an RN to MSN faculty scholarship that enables associate degree RNs to achieve master’s level nursing education, which credentials them to teach. The nursing faculty shortage would be significantly eased through creation of a program that directed just a fraction of the 21% of associate degree RNs who elect to obtain second undergraduate (bachelor’s) degrees to the nation’s 163 RN to MSN—registered nurse to master’s in science of nursing—programs. In exchange for RN to MSN scholarship funding, program recipients would commit to teach upon graduation.
  • Make community colleges eligible for participation in all new state-funded programs that enable nursing programs to expand their enrollments. Community colleges provide the most efficient and cost-effective means to high-quality nursing and allied health education.

Hospitals and other healthcare providers:

  • Provide faculty to teach in classroom and clinical settings, clinical sites, and resources to community college nursing and allied health programs. In addition to faculty shortages, community colleges most frequently cite a lack of clinical education facilities and preceptors (clinical faculty) as barriers to increasing nursing and allied health program enrollments.
  • Recognize the value of associate degree RNs. Provide equal opportunities and compensation to associate and bachelor’s degree RNs.
  • Encourage associate degree RNs who elect to continue their education to enroll in RN to MSN programs. Nursing programs cannot educate the RNs that hospitals need without an increase in the number of faculty. Hospitals can encourage and enable associate degree RNs to achieve graduate-level education through RN to MSN programs.
  • Partner with community colleges to secure federal funding. Congress has provided federal support to enable colleges to partner with health-care providers to increase numbers of health-care professionals.
  • Share board representation: Serve on community college boards and ensure that community college representatives serve on hospital boards. By working together, community colleges, hospitals, and health-care organizations can develop pragmatic community solutions.
  • Recruit high school students and others into healthcare careers. Collaborate with community colleges to increase awareness in secondary schools of the nursing and allied health professions.

 

Hearing Testimony:

108th Congress

National Advisory Council on Nursing Education and Practice:

The National Advisory Council on Nurse Education and Practice (NACNEP) advises the Secretary of the U.S. Department of Health and Human Services and the U.S. Congress on policy issues related to the Title VIII programs administered by the HRSA Bureau of Health Professions Division of Nursing, including nurse workforce supply, education and practice improvement. 

The 21 member Council is tasked with providing policy recommendations on nursing education, practice, and workforce to the Secretary and Congress.  In addition, NACNEP makes specific recommendations on Public Health Service Act, Title VIII, programs.  Read an overview of the Council and its responsibilities

For more information on NACNEP, visit http://bhpr.hrsa.gov/nursing/nacnep.htm

Public Laws:

  • Nurse Reinvestment Act - PL 107- 205 was signed into law by the President on August 1, 2002. This Act amends Title VIII of the Public Health Service Act and adds new authorities including Public Service Announcements; Loan Repayment and Scholarship Programs; Building Career Ladders and Retaining Quality Nurses Grants; Comprehensive Geriatric Education Training Programs and Nurse Faculty Loan Programs.   

    Review entire text of the Nurse Reinvestment Act on the Government Printing Office Web site.  http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=107_cong_public_laws&docid=f:publ205.107.pdf

    Summary of the Nurse Reinvestment Act as prepared by the Library of Congress:

    H.R.3487  

    Title: To amend the Public Health Service Act with respect to health professions programs regarding the field of nursing.

    Sponsor:
    Rep Bilirakis, Michael [FL-9] (introduced 12/13/2001)      Cosponsors (35)

    Related Bills: S.1864

    Latest Major Action: Became Public Law No: 107-205 [GPO: Text, PDF]

    SUMMARY AS OF:
    7/22/2002--Passed Senate amended.    (There are 2 other summaries)

    Nurse Reinvestment Act - Title I: Nurse Recruitment - Amends the Public Health Service Act to direct the Secretary of Health and Human Services to promote the nursing profession through public service announcements. Permits the Secretary to make grants to support State and local advertising campaigns, excluding particular employment opportunities.

Expands eligibility for the nursing loan repayment program to include service at any health care facility with a critical shortage of nurses. Restricts service to nonprofits after FY 2007.

Directs the Secretary to provide nursing scholarships in exchange for at least two years of nursing services at facilities with a critical shortage. Makes such program discretionary after FY 2004. Permits part-time service if the aggregate service equals two full-time years. Treats such scholarships, for repayment purposes, as equivalent to those made under the National Health Service Corps Scholarship Program, except as specified.

Grants preference according to financial need. Requires detailed, annual reports to Congress on the loan and scholarship programs, including numbers, demographics, and default rates. Leaves allocation of funds between the loan and scholarship programs to the discretion of the Secretary.

Title II: Nurse Retention - Authorizes the Secretary to award grants or contracts to schools of nursing or health care facilities to expand nursing opportunities: (1) in education, through increased enrollment in four-year degree programs, internship and residency programs, or new technologies such as distance learning; and (2) in practice, through care to underserved populations, care in noninstitutional settings or organized health care systems, and through developing cultural competencies. Makes career ladder programs and activities which enhance professional collaboration, communication, and decision-making eligible for a grant award.

Directs the Secretary to award grants for geriatric care training programs.

Authorizes the Secretary, acting through the Administrator of the Health Resources and Services Administration, to establish a student loan fund to increase the number of qualified nursing faculty. Cancels up to 85 % of such loan according to a schedule of employment milestones.

Requires the Comptroller General to study and report to Congress within four years on: (1) national variations in nursing shortages; (2) any differences in nurse hiring practices between profit and nonprofit private entities because of the inclusion of for-profit private entities in the loan repayment program; and (3) whether the scholarship program increased applications to nursing schools.

Authorizes appropriations for all programs for FY 2003 through 2007.

  • Nurse Education Act - The Nurse Education and Practice Improvement Act of 1998 (Public Health Service Act, Title VIII), also known as the Nurse Education Act (NEA), provides federal support for nursing education programs at various points on the continuum from entry-level preparation through graduate study. The NEA helps address the nursing shortage by enhancing opportunities for students to become nurses. The NEA supports three major grant programs; Advanced Education Nursing, Nursing Workforce Diversity, and Basic Nurse Education and Practice, and two loan programs, the Nursing Education Loan Repayment Program (NELRP) and the Nursing Student Loan (NSL) Program.

Nurses in Congress:

Rep. Lois Capps - Rep. Capps was born in Ladysmith, Wisconsin on January 10, 1938. After graduating with honors from Pacific Lutheran University in Tacoma, Washington with a Bachelor of Science degree in Nursing, she worked as a nursing instructor in Portland, Oregon. Capps earned a Master of Arts degree in Religion from Yale University while working as Head Nurse at Yale New Haven Hospital. In addition, she earned a Master of Arts degree in Education from the University of California, Santa Barbara.

Rep. Edie Bernice Johnson - Congresswoman Johnson began her career as a nurse. She obtained her nursing preparation from St. Mary’s College at the University of Notre Dame, and earned a Bachelor of Science degree in Nursing from Texas Christian University. She received a Master’s degree in Public Administration from Southern Methodist University, and subsequently served as the chief psychiatric nurse at the Veteran’s Administration Hospital in Dallas. Today, Congresswoman Johnson is one of two registered nurses in the U.S. House of Representatives. A businesswoman, Congresswoman Johnson has enjoyed a diverse career, including leadership in the private sector as founder of Eddie Bernice Johnson and Associates, a real estate business. She was a founding member of the Board of Directors of Sunbelt National Bank.

Rep. Carolyn McCarthy - Representative from New York; born Carolyn Cook in Brooklyn, Kings County, N.Y., January 5, 1944; graduated from Mineola High School, 1962; graduated, Glen Cove Nursing School, Glen Cove, N.Y., 1964; licensed practical nurse in ICU section, Glen Cove Hospital, Glen Cove, N.Y.; elected as a Democrat to the One Hundred Fifth and to the two succeeding Congresses (January 3, 1997-January 3, 2003). 

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