washington watch

By Rose Gonzalez, MPS, RN

Rose Gonzalez is an associate director in the ANA’s Department of Government Affairs.

nurse education

Funding Proposals Reflect Last Year’s Victory

Last year, nurses rallied to action when the Clinton administration proposed a paltry $7.7 million for fiscal year (FY) 1998 for the Nurse Education Act (NEA), $55 million less than the previous fiscal year. As a result of the ANA’s strong lobbying and grassroots efforts, the final funding was $65.6 million, a $300,000 increase over the previous fiscal year.

Indicating that the message was received and is still resonating, President Clinton released a budget proposal for FY 1999 that includes $65.6 million for the NEA. “We are pleased that the importance of funding the Nurse Education Act is being recognized,” said ANA President Beverly L. Malone, PhD, RN, FAAN. “With the growing complexity of health care delivery, it is imperative that we have the necessary tools to educate nurses to take their place on the frontlines of care.”

In the past several years, the ANA has submitted testimony before various congressional subcommittees on the issue of NEA funding. Most recently, the ANA testified before the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies regarding FY 1999 funding for nursing education, research, and work force programs. For NEA programs, the ANA requested an 8% increase over FY 1998, bringing it to $70.8 million for FY 1999. The ANA also recommended a 15% increase in funding for the National Institute of Nursing Research over FY 1998, bringing it to $73 million for FY 1999.

Despite organized nursing’s success in getting the funding restored last year and similar levels introduced in the FY 1999 budget proposal, potential roadblocks lie ahead. Funding for discretionary programs is limited because of the Balanced Budget Act of 1997, so strong competition for dollars is expected between health, education, and labor programs that are all funded under the same appropriations bill. The ANA is continuing to work with members of Congress to ensure adequate funding for those programs most important to nurses and the profession.

The ANA is also addressing a statement included in the FY 1999 budget proposal. The Department of Health and Human Services is proposing eliminating the Nursing Loan Repayment Program, stating that it was a duplication of the National Health Service Corps’s efforts. The ANA is working to clarify this misperception and to maintain funding for this program.

nea reauthorization

ANA Endorses Bill
Strengthening NEA Programs

While the House Appropriations Committee tackles the issue of funding for the Nurse Education Act programs, the members on the Senate side are reexamining the reauthorization parameters for funding. The NEA hasn’t been reauthorized since 1994. Last year, the Subcommittee on Public Health and Safety of the Senate Labor and Human Resources Committee held a hearing on how the U.S. health care work force must evolve to meet future needs. During the hearing, discussion centered on expectations for reauthorization of health professions education programs currently funded under Title VII of the Public Health Service Act, which includes all other health professions, and Title VIII, which includes the NEA. Subcommittee Chairman Bill Frist (R-TN) expressed strong support for these programs.

A year later, he made good on that support by introducing the Health Professions Education Partnerships Act of 1998 (S 1754). This would amend the Public Health Service Act to consolidate and reauthorize health professions and minority and disadvantaged health education programs. In this legislation, endorsed by the ANA, the NEA programs would be consolidated into the following three categories:

Strengthening Capacity for Basic Nurse Education and Practice

This program would provide support for nursing services in schools and community services, case management, development of cultural competencies among nurses, provision of emergency health services, and promotion of career mobility for nursing personnel in a variety of settings. It would also increase incentives for acute care hospital-focused diploma and associate degree programs to progress to baccalaureate degree programs, and provide for care of underserved populations and other high-risk groups such as the elderly, individuals with HIV or AIDS, or those with problems related to substance abuse and domestic violence.

Nurse Practitioners, Nurse Midwives, Nurse Anesthetists

This program would support training of these and other advanced practice registered nurses, including clinical nurse specialists, nurse educators, nurse administrators, and public health nurses. It would also subsidize projects related to advanced practice nurses.

Increasing Nursing Work Force Diversity

This program would provide for increased flexibility in the use of funds to enhance diversity in nursing education and practice.

“It’s my belief that all Americans should have access to the best quality health care our system can provide,” stated Senator Frist. “This bill would encourage more well-educated professionals to meet the health needs of traditionally underserved communities. The ANA’s support of this bill was an important part of its success, and I look forward to our continued efforts to provide the best patient care in the world.”

This reauthorization provides increased flexibility and effective authority for the support of health profession training programs and related community-based educational partnerships. The Senate Labor and Human Resources Committee approved the bill by voice vote. The bill must now be taken up by the full Senate.