1. A Federal Update on Title VIII Nursing Workforce Development Programs The Ties That Bind: Creating Partnerships and Collaboratives – Education, Practice, Interprofessional/Interdisciplinary Southern Regional Education Board Council on Collegiate Education for Nursing November 11, 2012 Julie Sochalski, Director, Division of Nursing U.S. Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions

2. Mission: To improve health and achieve health equity through access to quality services, a skilled health workforce and innovative programs. Health Resources and Services Administration (HRSA), U.S. Department of Health & Human Services 2

3.  Ensure the health workforce is trained to provide high quality care that is culturally and linguistically appropriate.  Increase the number of practicing health care providers to address shortages, and develop ongoing strategies to monitor, forecast and meet long-term health workforce needs.  Align the composition and distribution of health care providers to best meet the needs of individuals, families and communities.  Ensure a diverse health workforce.  Support the development of interdisciplinary health teams to improve the efficiency and effectiveness of care. Goal II of HRSA’s Strategic Plan Strengthen the Health Workforce 3

4. Mission: Increase the population’s access to health care by providing national leadership in the development, distribution and retention of a diverse, culturally competent health workforce that can adapt to the population’s changing health care needs and provide the highest quality of care for all. Bureau of Health Professions, HRSA 4

5. Division of Nursing Bureau of Health Professions, HRSA Mission: Provide leadership on policies and program initiatives that will promote the supply, skills and distribution of qualified nursing personnel needed to improve the health of the public. 5

6. Goals:  Enhance the composition, skills and distribution of the nursing workforce  Ensure program accountability through focused performance and outcomes assessment  Increase diversity and cultural competence of the nursing workforce  Promote effective communication with the public and stakeholders on nursing workforce development Division of Nursing Bureau of Health Professions, HRSA 6

7. History of Title VIII of the Public Health Services (PHS) Act  1 963-Surgeon General’s report, Toward Quality in Nursing, Needs and Goals 1  Nurse Training Act (NTA) of 1964 (P.L. 88-581)  Established Title VIII of the PHS Act, first comprehensive federal support for programs to develop the nursing workforce  On signing the act, President Johnson noted that the Nurse Training Act of 1964 was the most significant nursing legislation in the history of the country. 2 1 Department of Health, Education, and Welfare, “Toward Quality in Nursing, Needs and Goals.” Report of the Surgeon General’s Consultant Group on Nursing, Feb. 1963. 2 Lyndon B. Johnson: "Remarks Upon Signing the Nurse Training Act of 1964.," September 4, 1964. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency.ucsb.edu/ws/?pid=26484. 7

8.  Nursing Education and Practice Improvement Act of 1998  Amended by the Nurse Reinvestment Act of 2002  Amended by the Patient Protection and Affordable Care Act of 2010  Title VIII authorizes grants to institutions, and scholarships and loans to individuals, for basic and advanced levels of nursing education and grants to institutions and health facilities to support nursing practice and retention. History of Title VIII (cont’d): 8

9. Title VIII Programs Section 811 ANE Section 821 NWD Section 831 NEPQR Section 846 NELRP/NSP Section 846a NFLP Section 855 CGEP Supports Enhancement of Advanced Nursing Education and Practice I ncreases Access to Nursing Education for Disadvantaged Students Strengthens Nursing Education, Practice, Quality and Retention Financial Support for Current Students and New Graduates Increases the Number of Qualified Nursing Faculty Enhances Geriatric Care to the Elderly Geriatric Care Advanced Nursing Education Workforce Diversity Nursing Faculty Increasing the Pipeline of Nurses Recruitment and Retention

10. Title VIII Nursing Workforce Development Fiscal Year (FY) 2012 Funding $63,925,000 Advanced Nursing Education Advanced Education and Nurse Anesthetist Traineeships. $39,578,000 Nurse Education, Practice, Quality & Retention Program Faculty Development--Integrated Technology into Nursing Ed. & Practice Nursing Assistant and Home Health Aide Program Coordinating Center-Interprofessional Education & Collaborative Practice $15,979,000Nursing Workforce Diversity $83,135,000 Nurse Scholarship Program Nursing Education Loan Repayment Program $24,801,000Nurse Faculty Loan Program $4,530,000Comprehensive Geriatric Education Program 10

11. HRSA Strategic Priorities and Division of Nursing Primary care Interprofessional education and practice Innovative practice models Health care technology Care coordination Workforce diversity Population health and preventive care Community-based training Veterans health and health careers 11

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16. Patient Protection and Affordable Care Act of 2010 Programs and Policies Increased funding for health professions training Expanded National Health Service Corps and community health centers Supported service delivery innovations and new models of care Established Centers for Medicare & Medicaid Services Innovations Center Established National Center for Health Workforce Analysis 16

17. National Center for Health Workforce Analysis Build on existing sources of data including from professional associations, states, and federal agencies Strengthen national and state capacity for data collection and analysis including within professional associations and states Develop and promote a national uniform minimum data set Support research to better understand current and future workforce needs and dynamics 17

18. Key National Health Workforce Questions 1.Will there be enough nurses, physicians, and other health care providers to ensure access? 2.What can/should be done to increase the supply, skills and distribution of the health care workforce? 3.How can we make full use of all health care workers? 4.How can we improve the efficiency and effectiveness of health care service delivery? 18

19. Drivers of Future Demands for Services  Population growth: U.S. population to grow by around 30 million in next decade 1  Medical advances and successes  Increased incidence of chronic diseases  Insurance coverage expansion 1 U.S. Census Bureau “Projections of the Population and Components of Change for the United States: 2010 to 2050” ( http://www.census.gov/population/www/projections/summarytables.html,accessed August 10, 2012). 19

20. Recent Trends and Implications for Future Workforce Development Cost pressures and shortages will encourage innovation and systems redesign Primary care will broaden its focus to integrate oral health, behavioral-mental health and population-focused care Role of technology/HIT will continue to grow Strong incentives to make better use of current workforce and allow health personnel to work at top of their license Workforce diversity is becoming pathway to improve access and reduce health disparities 20

21. Contact Information Julie Sochalski, PhD, RN, FAAN Director, Division of Nursing U.S. Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions 301-443-5688 JSochalski@hrsa.gov 21