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Washington Watch

American Journal of Nursing - November, 2002 - Volume 102, Issue 11

The Nurse Reinvestment Act
Putting the law into action one step at a time.

By Erin McKeon

On August 1 ANA president Barbara Blakeney, MS, APRN,BC, ANP, attended an Oval Office ceremony where President Bush signed the Nurse Reinvestment Act into law. This event capped a two-year effort by the ANA to secure passage of this nursing-shortage legislation, which contains many initiatives that hold the promise of attracting a new generation of nurses to the profession. That this bill was enacted by a fractured Congress embroiled in partisan bickering is a great achievement on many fronts, but the work is not complete.

The programs of the Nurse Reinvestment Act will not be­come a reality until they receive funding. The ANA is now actively seeking $250 million in new appropriations for the programs of the Nurse Reinvestment Act.

What the Law Will Do
The Nurse Reinvestment Act (PL 107-205) expands authority for some existing federal programs and creates a number of new ones. Nearly all of the provisions of this law will be administered by the Division of Nursing at the Health Resources and Services Administration (HRSA), which is part of the U.S. Depart­ment of Health and Human Services. Specifically, the new law

• expands loan repayments and establishes scholarships for nursing students who commit to working in a health care facility deemed to have a critical shortage of nurses.
• establishes “Nurse Retention and Patient Safety Enhance­ment Grants” based upon criteria of the Magnet Recog­­nition Program, administered by the ANA’s subsidiary, the American Nurses Credential­ing Center. These competitive grants would encourage health care facilities to increase collaboration between nurses and other health care professionals and to promote nurse involvement in the governance of the facility with the ultimate goal of increasing nurse retention and improving patient care.
• establishes geriatric training grants to support educators and nursing students who provide care to the elderly.
• establishes a nursing faculty loan cancellation program for master’s and doctoral students who commit to working as full-time faculty after completing their degree.
• establishes a career ladder program to create partnerships between health care facilities and schools of nursing to support nurses and nurses aides who wish to advance within the profession, and to establish preentry programs for nursing students.
• establishes grants for public service announcements to educate the public regarding nursing and to promote student aide programs. State nurses associations would be eligible to receive some of these grants.

Implementing the New Law
Unfortunately, the vast majority of these programs will not begin to be implemented until legislation enacting federal funding for Fiscal Year (FY) 2003 is passed. The ANA is working with associations representing hospitals, health systems, nursing homes, nurse executives, and schools of nursing to educate Congress regarding the need to invest in these programs. The ANA worked with Representatives Lois Capps (D-CA) and Edward Whitfield (R-KY) on a letter signed by 237 members of the House from both parties. Sent to the House appropriations leadership, the letter urged support for full funding. However, the tight budget environment and the pressure of the November elections have been complicating the FY 2003 appropriations process.

At press time, Congress had deferred appropriations work until December.

Given the unusually slow progress of the FY 2003 appropriations, and the need for HRSA to promulgate regulations enacting the Nurse Reinvestment Act, it is unlikely that these new programs will become operational before mid-2003. Updates will be available on the HRSA Web site (http://bhpr.hrsa.gov/nursing) and on the ANA Web site (www.NursingWorld.org).

In the meantime, HRSA is preparing for a new round of applications for the previously existing Nurse Education Loan Repayment Program, which provides loan repayments totaling as much as 85% of the debt load of nursing students who agree to work for two or three years in a facility deemed to have a critical shortage of nurses. Information is available at bhpr.hrsa.gov/nursing/loanrepay.htm.

Erin McKeon is an associate director of the Department of Government Affairs at the ANA.

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