FOR IMMEDIATE RELEASE/February 7, 1997 CONTACT: Sara Foer [202/651-7023]; Joan Meehan [202/651-7020] Clinton Budget Contradicts State of the Union Message, Says American Nurses AssociationAbandons nurse education, patient access and protectionCalling proposed cuts in funding for health care programs alarming and contradictory to the priorities he articulated in his State of the Union address, the American Nurses Association (ANA) today denounced President Clinton's attempt to balance the budget by slashing critical programs in his Fiscal Year (FY) 1998 budget. ANA was particularly appalled to learn that one of the ways Clinton is planning to implement his $1.7 trillion budget and move towards a balanced budget is by gutting funding for the Nurse Education Act (NEA). Funding for FY '98 is proposed at $7.7 million -- down from $63 million for FY '97. "We are extremely disappointed by the president's budget proposal," said ANA President Beverly L. Malone, PhD, RN, FAAN. "Without stable funding to support graduate-level education for nurses, we'll enter the 21st century ill-prepared to provide adequate health care to aging baby boomers and their grandchildren. "The administration has promoted excellent public policy through greater use of advanced practice nurses as a cost-effective way to increase access to primary and preventive health care services, yet this budget proposal would force some programs to close completely and it would dramatically affect some 4,000 students who rely on traineeships to make their education possible," she said. "Thousands of today's registered nurses, including many single mothers and those who came from low-income families, relied upon NEA funds in order to become professional nurses," explained Malone. "Given President Clinton's emphasis on improving access to health care for children and the elderly, his obsession with education, and his commitment to helping the unemployed, particularly welfare mothers, move to gainful employment, we are absolutely stunned by his abandonment of nurse education," said ANA Executive Director Geri Marullo, MSN, RN. Despite the unanticipated setback, ANA and its state nurses associations plan to take their message to Congress, where the association has received bipartisan support for its priority issues, particularly support for NEA funding. The Nurse Education Act, funded under Title VIII of the Public Health Service Act, provides the lion's share of federal support for nurse education, the largest of the health professions. These funds support graduate-level programs primarily, which enroll approximately 30,000 students annually. These programs prepare registered nurses to assume advanced practice roles. Advanced practice registered nurse (APRN) is an umbrella term given to a registered nurse (RN) who has met advanced educational and clinical practice requirements beyond the 2-4 years of basic nursing education required for all RNs. The four principal types of APRNs are nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, and certified nurse-midwife. In addition, monies in Title VIII fund nurse-managed clinics affiliated with university schools of nursing. Last year, these clinics, staffed by nursing students and faculty, provided more than 32,000 primary care visits to a range of underserved populations, such as poor children and elderly in many inner cities. According to the Bureau of Labor Statistics demand for health care professionals is expected to grow by 47 percent by the year 2005, with the need for APRNs among the greatest. APRNs, such as nurse practitioners and clinical nurse specialists, are increasingly in demand to meet the broad health care needs of Medicare beneficiaries. An Institute of Medicine report on the role of nursing staff in hospitals and nursing homes released last January found that "more advanced, or more broadly trained, RNs will be needed in the future . . . Such training is essentially like that now provided for RNs who receive certification as, for example, advanced practice registered nurses." Funding for other health professions education was also slashed. Funding for primary care and allied health professions education was cut, by 90 and 56 percent respectively. "The education of future health professionals has always been a sound investment of federal funds," said Marullo. "Yet, according to the explanation that accompanied this budget, the Clinton Administration no longer believes the federal government has a role in preparing the care givers of tomorrow." Furthermore, ANA is also distressed that the administration proposes to cut Part A (hospital reimbursement) of the Medicare program by $45 billion over six years without providing needed mechanisms for holding hospitals accountable for providing safe patient care, such as requiring public disclosure of nurse staffing levels and patient outcomes. "Several recent consumer surveys echo the concerns expressed by nurses during the past two years about the current direction of health care, where quality of care -- and the nurses who provide it -- are sacrificed in the name of cost-containment," said Marullo. "Medicare cuts of this magnitude, without patient protections, will exacerbate an already dangerous trend where hospitals substitute cheaper, minimally-skilled technicians for registered nurses in a short-sighted attempt to cut costs." On a positive note, the administration included a provision to provide direct Medicare reimbursement to all clinical nurse specialists and nurse practitioners, a long-standing goal of ANA, which will increase consumers' access to health care services.
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