Kathleen A. Ream Director, Government Affairs October 1, 2010

 March 23, Patient Protection and Affordable Care Act (PPACA), P.L  September 23, Patient’s Bill of Rights 2

 Incentives to Educate More Nurses  Increases Demand for Highly-Skilled Nurses  Quality Incentives  Other Practice Opportunities  Boards, Commissions, Councils, and Panels 3

PPACA is an authorization bill. Many of its provisions will require appropriated funding. 4

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 Expands the educational loan repayment amount from $30,000 to $35,500  Creates “Eligible Individual Student Loan Repayment” program  Increases loan repayment amounts up to $40,000 for master’s & $80,000 for doctoral  Funding priority to doctoral students to impact nurse faculty shortage 6

 Effective January 1, 2012 thru 2015  $200 Million for Demo Projects  Medicare payments to hospitals for clinical training costs of preparing APRNs – nursing’s equivalent to GME  Partnership created among hospitals, accredited schools of nursing, and non-hospital community-based care settings 7

 Eliminates 10% cap on doctoral programs for AEN grants  Allows funds to go directly to students not only to schools 8

 Nurse faculty now included as eligible participants  For repayment must serve as faculty at an accredited nursing school for two years 9

 Grant program now titled “Nurse Education and Practice Grants”  Nurse Retention gets own section  Expands career ladder programs, funding for nursing internships and residency programs in collaboration with accredited schools of nursing 10

 Now includes nursing faculty as eligible participants  Increases aggregate amount of student loan from $13,000 to $17,000  Increases student loan amounts from $2,500 to $3,500  Increases student loan amounts for final two years from $4,000 to $5,200 11

 PPACA creates a CGE Traineeship that provides funding to students for tuition, books, and stipends  No funding has yet been appropriated for FY

 Provides stipends for diploma or AD nurses to enter bridge programs  Provides scholarship or stipends for accelerated degree programs, pre-entry preparation, advanced education preparation, and retention activities 13

 Two other types of nursing programs are now eligible for Title VIII funding:  “Accelerated” BSN or MSN programs  “Bridge” BSN or MSN programs 14

 Scholarship & Loan Repayment Programs for students in accredited health professions education program in exchange for 2-4 years of service in a health professional shortage area  Aimed at FNPs and CNMs 15

 Program will educate providers in primary care, prevention, chronic care management, mental and behavioral health, and evidence- based practice  Provision uses the IOM definition of primary care which includes nursing 16

 NP Residency program in federally qualified health centers or nurse managed health clinics  Awarded health centers need to have at least 3 NP residents in training program  Preference given to bi-lingual nurse practitioners 17

 Began FY 2010  Organized to annually graduate at least 250 nursing students  Students receive tuition and stipend for no more than 4 years  Upon degree completion, awardees serve two years for each year they were supported 18

 Loan repayment program to drive clinicians to provide pediatric health care in underserved areas for 2 years  Providers include psychiatric nurses for the Child & Adolescent Behavioral Health provision  Up to $35,000 in loans/year will be repaid for a maximum of 3 years 19

 Creates strong expansion opportunity for Nurse-Family Partnership  $1.5 billion mandatory funding over 5 years – FY 2010 thru FY

 Payment incentive and service delivery model  Utilizes physician and NP directed home-based primary care teams  $30 million mandatory funding over 6 years – FY 2010 thru FY

 NPs can direct SBHCs  Comprehensive primary health services for medically underserved children & adolescents  Available for both building capacity in existing SBHCs and to create new ones  $200 Million mandatory funding over 5 years – FY 2010 thru FY

 Increases payment for CNMs from 65% to 100%  Increases payments to NPs and CNSs by 10% for primary care & health professional shortage areas services 23

 Grant program to create health care workforce development strategies at state & local levels  Planning grants for no more than 1 year with largest award no more than $150,000  Eligible partnerships must include 2- year & 4-year public institutions of higher education 24

 Independent Medicare Advisory Board  National Health Care Workforce Commission  Patient Centered Outcomes Research Institute  Advisory Board on Elder Abuse, Neglect and Exploitation 25

 No Pre-Existing Condition Exclusions for Children Under Age 19  No Arbitrary Rescissions of Insurance Coverage  No Lifetime Limits on Coverage 26

 Restricted Annual Dollar Limits on Coverage  Protecting Your Choice of Doctors by removing insurance barriers  Removing Insurance Company Barriers to accessing ED Services 27

NLN’S GOVERNMENT AFFAIRS HOMEPAGE affairs/index.htm 28