Legislative: The American Recovery and Reinvestment Act of 2009: What's in It for Nursing?
Alexandre, Charles, Glazer, Greer, Online Journal of Issues in Nursing
Citation: Alexandre, C., Glazer, G., (June 22, 2009) "Legislative: The American Recovery and Reinvestment Act of 2009: What's in it for Nursing?" OJIN: The Online Journal of Issues in Nursing Vol. 14 No. 3. Available: www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Columns/Legislative/American -Recovery-and-Reinvestment-Act-.aspx
On February 13, 2009, the United States (U.S.) Congress approved the conference report that became the American Recovery and Reinvestment Act of 2009 (H. R. 1). The Recovery Act was signed into law by President Barack Obama on February 17, 2009, setting in motion a series of events that will make $789 billion available to jumpstart the falling economy by creating jobs and mending a crumbling national infrastructure. Daily reports in the media document the billions of dollars to be transferred to the states to implement shovel-ready projects, such as repairing bridges and highways; to fund education; and to alleviate growing state budget deficits. Less well known however are myriad other plans for federal stimulus dollars including a significant amount of money that will benefit nursing.
As we all know by now, the current shortage of nurses is well documented. In an earlier article for this column Glazer and Alexandre (2008) defined the current shortage as a public health issue. Our failure to find a resolution to this shortage will likely have long-term consequences for the U.S. healthcare system. A recent report of the Association of American Medical Colleges (2008) predicted an impending shortage of physicians lasting at least through 2025. Advanced practice nurses, specifically nurse practitioners, are poised to fill this gap as primary care practitioners. In fact, a recent issue brief from the Robert Wood Johnson Foundation (2009) reported nurse practitioners make more primary care patient contacts than any other Medicare B fee-for-service provider.
The value of nursing to the overall success ofthe U. S. healthcare system has been long recognized by the federal government. Washington has demonstrated its support for nursing by funding nursing education since the inception ofthe Nurse Corps in 1943 (Willever-Farr & Parascandola, 1994). Through the ensuing decades Congress has continued to support nursing education through Titles VII and VIII ofthe Public Health Service Act providing funds for construction grants for schools of nursing, grants for education, student loan assistance, and traineeships for advanced practice nurses (ReyesAkinbilege & Coleman, 2005). The Recovery Act continues federal support of nursing by expanding the funding of current programs and creating new opportunities for nursing practice, education, and research.
Acknowledging the need to educate sufficient numbers of nurses to meet the expected demand in the coming years, the Recovery Act allocates $500 million, of which $300 million targets the National Health Services Corps, with the remaining $200 million divided between the Title VIII Nursing Workforce Development Programs and the Title VII Health Professions Training Programs. Each of these programs will be discussed further in the paragraphs below. This money is in addition to that allocated in the fiscal year 2009 budget and to what is anticipated in the President's 2010 budget proposal. In addition, $10 billion dollars has been awarded to the National Institutes for Health, with $7.4 billion ofthat allocated directly to the Institutes, including the National Institute for Nursing Research (AACN, 2009). The Recovery Act has infused an unprecedented bolus of federal funding in programs that can benefit nursing. What does this really mean for nurses and who will actually benefit from this infusion of cash?
The $500 million allocated to the National Health Services Corps and workforce development and training will be administered by the Health Resources and Services Administration (HRSA). Oversight by HRSA is especially significant because President Obama recently named a nurse, Mary Wakefield, PhD, RN, FAAN, as HRSA Administrator, reinforcing the Obama Administration's commitment to the profession and ensuring nursing's seat at the policy table. …