FOR IMMEDIATE RELEASE/February 4, 1998 CONTACT: Sara Foer [202/651-7023]; Joan Meehan [202/651-7020];
American Nurses Association Praises Administration's FY'99 BudgetNursing Education Receives Level Funding, ANA Requests Increase to Meet NeedWashington, D.C. --Calling the first balanced budget in 30 years a move in the right direction, the American Nurses Association (ANA) today applauded President Clinton's proposed Fiscal Year (FY) 1999 budget. ANA was particularly gratified that, as mentioned in his State of the Union address, Clinton's budget proposal places an emphasis on the quality of patient care. The FY '99 budget for the Department of Health and Human Services (HHS), in which funding for nursing research is included, totals $380.8 billion, a $21.7 billion, or 6 percent, increase over FY '98. The FY '99 budget request for the Health Resources and Services Administration (HRSA), which also pertains to the needs of the ANA and the nurses it represents, equals $3.8 billion, an increase of $161 million over FY '98. HRSA programs of particular interest to ANA are those that provide access to quality health care for low-income and underserved populations and promote the health professions work force, particularly in primary care and public health. Funding for nurse education in FY '99 is proposed at $65.6 million, the level at which it was funded in FY '98. "Level funding for the Nurse Education Act (NEA) is a positive step toward quality; however, the unprecedented changes in our health care delivery system, coupled with changing demographics and complexity of care, underscore the critical need for increased federal funding for nurse education programs and nursing research," said ANA President Beverly L. Malone, PhD, RN, FAAN. Given last year's uphill battle to secure adequate funding, ANA characterizes this year's budget proposal as a victory for nursing and a testament to effective grassroots lobbying efforts. Throughout 1997, ANA, its state nurses associations (SNAs) and their members actively lobbied Congress in support of NEA funding through the Nurses Strategic Action Team (N-STAT), a grass-roots network of more than 50,000 nurses. "We are pleased by the president's budget proposal, however, as front-line care givers we see the need for additional funding to ensure the future of health care for all citizens," added Malone. "Additional funding to support graduate-level education for registered nurses is critical, so that we'll enter the 21st century 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 registered nurses (APRNs) as a cost-effective way to increase access to primary and preventive health care services, and this budget proposal enforces the administration's commitment to the success of such programs, which benefit thousands of Medicare beneficiaries. Following the release of the budget on February 2, the ANA testified on the need for increased funding for nurse education and research. Vice Chair of ANA's Council for Community-Based, Primary, and Long Term Care Practice, Marge Drugay, ND, RN, C, a clinical nurse specialist in private practice, represented ANA and its 53 constituent nurses associations. Offering compelling testimony before the United States House of Representatives Committee on Appropriations' Subcommittee on Labor, Health, and Human Services, Education and Related Agencies, Drugay called for an increase in funding for nurse education and research. With respect to nurse education, Drugay requested an increase of 8 percent over the proposed $65.6 million, bringing the new amount to $70.8 million. As health care shifts from the hospital setting to community-based sites, and the types of health care services needed become more complex, the demand for highly skilled RNs also will increase. In addition, the recent trend to reduce RN staffs and increase the use of unlicensed assistive personnel, sometimes referred to as nurses' aides, patient care associates, patient care technicians, or nursing assistants, has proved unsatisfactory, producing poor outcomes, and prompting more hospitals to boost RN recruitment. Furthermore, according to the U.S. Bureau of Labor Statistics, employment of R.S. will increase, faster than the average for all occupations, through 2006. The demand for more RNs also will be fueled by converging demographic trends, an aging population overall, as well as an aging RN work force. In 1996, according to the Division of Nursing, the average age of RNs in the U.S. was 44 years and only 9 percent of the nation's 2.6 million registered nurses were under the age of 30. "Federal support for nursing education under Title VIII is essential," said Drugay. "This is the only federal money earmarked for nurse education, including support for curriculum development and other programs to help change the focus of nurse education from acute care settings to community and home settings, where there is a greater demand," she continued. "Another advantage is that this funding will assist in expanding the numbers of minority nurses who provide culturally competent, linguistically appropriate health care services to underserved communities." The Nurse Education Act, funded under Title VIII of the Public Health Service Act, provides the lion's share of federal support for education of nurses, the largest of the health professions. These funds primarily support graduate-level programs, which enroll approximately 30,000 students annually. These programs prepare registered nurses to assume advanced practice roles. APRN is an umbrella term given to an 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 the 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 130,000 primary care visits to a range of underserved populations, such as poor children and elderly in many inner cities. The second priority for ANA and nursing is funding for the National Institutes of Nursing Research at the National Institutes of Health. Applauding the subcommittee's commitment to advancing behavioral science research, ANA emphasized the benefits of nursing research as an integral part of effective nursing care. "Nursing care has shown us that prevention works, and nurses are applying that research in clinical practice," said Malone. For example, in Illinois, APRNs have developed a wellness model geriatric health risk appraisal, based on the principles of the Department of Health and Human Services Initiatives of Healthy People 2000 and Put Prevention into Practice. These nurses help older adults between the ages of 55 and 65 to assume personal responsibility for changing their lifestyles and improving their health status, which ultimately results in reducing health care costs. Although ANA supports the administration's proposed funding level of $68.3 million for this program, ANA recommends increasing the FY '98 level of 63.5 million by 15 percent, bringing the total to $73 million .
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