Governmental Affairs Update

January - February 2005

Gena Near, BSN, RN, CPAN

Governmental Affairs Committee Chair

ANSR Update

Conference Call on 1-6-05

·         FY 2006 Appropriations

o        The ANSR Alliance members on the call agreed to support the suggested nursing community FY 2006 appropriations level of $210 million

·         Appropriations Advocacy

o        The House and Senate will soon be scheduling hearings for the FY 2006 appropriations cycle

o        The ANSR Alliance groups agreed to send a letter to the House and Senate to request an opportunity for ANSR to testify in support of the nursing education funding level

o        If ANSR is invited to testify, ANSR organizations will meet to discuss a process for identification of the ANSR Representative to testify and the development of the testimony

o        David Whitcomb, AWHONN, will circulate a copy of the letter after it is sent

·         ANSR Hill Event

o        The ANSR Reception will be on Capitol Hill in the Cannon House Office Building on March 1, 2005, from 1730 to 1930

o        It is estimated that from 1800-1830 awards will be given

o        The expected budget from the reception is $11,000 for 250 people

o        Every group that is a member of ANSR will receive one ticket to attend (Gena Near to represent ASPAN)

o        Groups will receive more tickets depending on the funding level

·         Review of the ANSR Alliance Consensus Document

o        Kathi Ream will lead a group of interested ANSR Alliance members to review and update the consensus document (CD)

·         ANSR Alliance Website

o        There was discussion about ANSR looking into creating a Web site so people can more easily find information about ANSR and learn about the issues

o        Kathi is exploring George Mason University as an option for hosting a Web site

·         Upcoming Meetings

o        Kathi will be setting up a meeting with Pat Grady at NINR (National Institute of Nursing Research) to discuss issues related to NINR

o        We anticipate there will be other meetings set up in the next few months

Sign On Letter

• ASPAN signed on to a  letter to send to President Bush and Members of Congress urging that an increase of $3.5 billion (+7%) be provided for Function 550 in the FY 2006 Budget Resolution

• The letter is essentially worded exactly as last year’s letter that 400 health organizations signed onto

• The $3.5 billion figure was developed by the leadership of the Health Summit coalition groups working with their memberships—consensus emerged that this dollar amount allows all coalitions room to advocate for their specific agencies, or parts of agencies, but also reflects the reality of severe budget constraints and major funding challenges in the coming fiscal year

• I sent a copy of this letter to all ASPAN Component Presidents

ANSR Alliance Public Service Award

• This award honors on a nonpartisan basis deserving congressional leaders who contribute to the advancement of nursing and/or health care in the US

• The principal criteria established for the recipient(s) are:

  • Active leadership in the determination of health care policy

  • Strong public advocacy in support of nursing

  • Specific actions taken to advance health care policy as delineated in the Alliance’s Consensus Document

• Each ANSR Alliance organization gets one vote

• By the deadline of January 17, 2005, the Nomination Committee received 8 nominations representing 6 individual nominees and 2 joint nominations

• Based upon the criteria established for the Award, the committee recommends that Senator Barbara Mikulski (D-MD) and Senator Susan Collins (R-ME) jointly receive the 2005 ANSR Public Service Award

• The rationale:

  • Senators Mikulski and Collins are the Senate advocates who were most instrumental in ushering the funding increases that have occurred in the Title VIII-Nursing Workforce Development Programs over the past 3 funding cycles

  • Prior to that, they helped steer the Nurse Reinvestment Act through the Senate

  • If it were not for their bipartisan determination, political savvy, and their willingness to pigeonhole their fellow Senators on the Senate Floor prior to key votes, the nursing community’s efforts in this area would not have been as successful

  • Their strong public advocacy on behalf of nursing is making a difference

FY 2006 Proposed Budget for Title VIII-Nursing Workforce Development Programs

• The following is a breakdown of the FY 2006 budget that was released on 2-7-05—it is about what we expected:

**$8 million for both programs—don’t know individual program breakdown yet

US NURSING SCHOOLS ENROLLMENT/CHALLENGES

• The American Association of Colleges of Nursing (AACN) announced on December 15, 2004 that enrollment in entry-level baccalaureate programs in nursing increased by 10.6% in 2004 over the previous year

• Nursing colleges/universities denied 26,340 qualified applications this year due primarily to a shortage of nurse educators

• The government has projected a shortfall of 800,000 nurses by the year 2020

• AACN’s latest data confirm that interest in nursing careers continues to grow

• For the first time, the US Department of Labor has identified Registered Nursing as the top occupation in terms of job growth through the year 2012

• According to the latest projections, more than 1 million new and replacement nurses will be needed by 2012

• The growing interest in nursing careers can be attributed in part to outreach efforts by nursing schools as well as sustained image campaigns launched by Johnson & Johnson and the Nurses for a Healthier Tomorrow coalition

• www.aacn.nche.edu/Media/NewsReleases

• www.nursing world.org

EMERGENCY PUBLIC HEALTH AND MEDICAL RESPONSE

·         On January 10, 2005, Health and Human Services (HHS) Secretary Tommy Thompson announced that under the new National Response Plan released by the Department of Homeland Security, HHS will continue to lead the federal government in providing public health and medical services during major disasters and emergencies

·         The National Response Plan divides the government’s emergency operations into 15 emergency support functions

·         HHS is the lead agency for Emergency Support Function Eight (ESF-8)—public health and medical services

·         In this role and through the HHS Secretary’s Operations Center, the department coordinates all federal resources related to public health and medical services made available to assist state, local, and tribal officials during a major disaster or emergency

·         A copy of the National Response Plan is available online as a PDF file at:  www.dhs.gov/nationalresponseplan

·         www.nursingworld.org

AHRQ RELEASES 2004 QUALITY AND DISPARITIES REPORT

·         The Agency for Healthcare Research and Quality (AHRQ) February 22 released the second annual reports on quality and disparities in health care

·         The reports build upon the baseline data on quality and disparities within health care delivery provided in AHRQ’s 2003 reports

·         Compared to the 2003 report, there have been modest improvements for many quality measures—for example, quality has improved by approximately 3% versus 2003 data, according to measures used by the Centers for Medicare and Medicaid Services (CMS), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the National Committee for Quality Assurance, and others for quality reporting on hospitals, nursing homes, home health agencies, and other settings

·         Best practices have been identified and stakeholders have made inspiring gains

·         The disparities report presents data on clinical conditions such as cancer, diabetes, and heart disease, with a focus on specific priority populations, including women, children, the elderly, racial and ethnic minority groups, low-income groups, residents of rural areas, and individuals with special health care needs

·         The report identifies 3 key themes:

1.        disparities are pervasive

2.       improvement is possible

3.       gaps in information exist, especially for specific conditions and populations

·         www.aamc.org/advocacy/library/washhigh

BUSH SUBMITS FY 2006 BUDGET

·         On February 7, President Bush revealed the details of his FY 2006 budget request to Congress

·         The $2.568 trillion spending plan assumes a $390 billion deficit in FY 2006, and calls for $840 billion in discretionary spending, an increase of $17.6 billion (2.1%)

·         Defense spending is increased by 4.8% and homeland security grows by 3.2%

·         All other discretionary spending is slated for a 0.5% decrease to $389 billion

·         The President’s budget also proposes new budget reforms, including capping discretionary spending at the FY 2006 level for 5 years, a stricter standard for emergency spending designations, and a requirement that the President and Congress concur in those designations, and a line—item veto

·         Discretionary spending within the HHS Department is decreased by nearly $1.8 billion (2.6%) to $67.1 billion

·         The following is a summary of the discretionary budget proposals for programs of interest to those working in health care:

o        National Institutes of Health (NIH):

§         Program level of $28.845 billion (0.7% increase)

§         This includes a request for appropriations through the Labor-HHS-Education Appropriations Subcommittee of $28.510 billion (0.5% increase)

§         This also includes $80.3 million through the VA-HUD Appropriations Subcommittee for the National Institute of Environmental Health Sciences Superfund research program, $150 million for diabetes research, and $97.1 million through the department’s Public Health and Social Services Emergency Fund (PHSSEF) for research on radiological/nuclear/chemical countermeasures

§         This budget supports an estimated 9,463 new and competing renewal research project grants (RPGs), an increase of 247 competing RPGs over FY 2005 (the average cost for a competing RPG is $347 thousand

§         Individual post-doctoral fellows will receive an increase of $500 in their institutional allowance for rising health benefits costs

§         NIH will support a total of 17,442 Full-Time Training Positions (FTTPs) in FY 2006 (397 decrease)

§         Budget includes $30 million for construction of additional biosafety level (BSL) 3 laboratories for biodefense research

o        Health Professions

§         For the fourth consecutive year, the budget eliminates all funding for the Title VII health professions programs, with the exception of $10 million for Scholarships for Disadvantaged Students and $1 million for Workforce Information and Analysis

§         Title VII nursing receives level funding with FY 2005 at $150 million

§         The children’s hospital graduate medical education program receives a cut of $101 million (33%) below last year’s level of $301 million

o        National Health Service Corps

§         The budget includes $127 million ($5 million decrease)—the decrease is the result of proposed administrative cost savings, and the number of awards is anticipated to remain the same

o        Preparedness

§         The Health Resources and Services Administration (HRSA) Bioterrorism Hospital Preparedness program is cut by $8 million to $483 million

§         Funding for the Bioterrorism Curriculum Development program is level funded at $28 million

§         The State Bioterrorism Preparedness program administered by the Centers for Disease Control and Prevention (CDC) is cut by $130 million to $797 million

§         Also within CDC, $203 million is added to the Strategic National Stockpile

o        AHRQ

§         Receives level funding at $319 million (all funds allocated via transfers from other public health service agencies)

§         The budget designates $50 million for health information technology, $34 million for patient safety, and $15 million for comparative effectiveness research

o        Health IT

§         Outside AHRQ, the budget includes $75 million for the new Office of the National Coordinator for Health Information Technology

§         Congress did not provide funding for this initiative in the final FY 2005 budget, however the Administration has directed $50 million in FY 2005 funds from the Secretary’s discretionary budget

o        VA Research

§         Includes $393 million for the direct costs of research in the Department of Veterans Affairs medical and prosthetics program (decrease of 2.3%)

§         Proposes to establish 3 new performance measures for the VA research program:

1.        the percentage of clinicians who remain paid VA employees at least 3 years after completion of a career development award

2.       the annual number of patent disclosures filed by VA investigators

3.       the annual number of peer-review publications that show VA listed as the affiliated institution

o        VA Medical Care

§         Includes $30.7 billion for VA medical care (2.5% increase)

§         This includes $2.59 billion in collections and revenue generated through proposed legislation

§         Includes $28.1 billion for medical care (0.04% increase)

o        National Science Foundation

§         Includes $5.61 billion (increase of 2.4%)

o        Higher Education

§         Includes several proposals related to the reauthorization of the Higher Education Act—those of interest include:

·         Eliminating the Perkins Loan Program and reclamation of the federal portion of the revolving fund;

·         Increasing annual subsidized Stafford loan limits for freshmen to $3,500 and for sophomores to $4,500;

·         Increasing annual unsubsidized Stafford loan limits for graduate and professional students to $12,000;

·         Maintaining current variable interest rate on Stafford loans;

·         Replacing the current fixed-rate formula on consolidation loans with a variable rate;

·         Allowing reconsolidation on multiple occasions subject to a 1 percent borrower origination fee; and

·         Eliminating the single holder rule

ON THE HILL

Nurses in the 109^th Congress

·         Representative Lois Capps, RN (D-CA)

o        Committees:

§         Budget

§         Energy and Commerce

·         Energy and Air Quality Subcommittee

·         Health Subcommittee

o       Founder:

§         Bipartisan School Health and Safety Caucus

§         Bipartisan Nursing Caucus

o       Co-Chair:

§         Medicare Task Force

§         Congressional Heart and Stroke Coalition

§         Congressional Hearing Health Caucus

§         House of Representatives Coastal Caucus

§         House of Representatives Cancer Caucus

·         Representative Eddie Bernice Johnson, RN (D-TX)

o       Committees:

§         Transportation and Infrastructure (Ranking Member)

·         Water Resources and Environment Subcommittee

·         Aviation Subcommittee

·         Rail Roads Subcommittee

§         Science

·         Research Subcommittee

·         Energy Subcommittee

·         Representative Carolyn McCarthy, LPN (D-NY)

o       Committees:

§         Education and Workforce

§         Financial Services

Secretary of Education

• On 1-6-05 the Senate Health, Education, Labor, and Pensions (HELP) Committee favorably reported the nomination of Margaret Spellings to be Secretary of Education

Secretary of Health and Human Services

• On 1-19-05 the Senate Finance Committee held a confirmation hearing on the nomination of Michael O. Leavitt to be Secretary of Health and Human Services (HHS)

• Mr. Leavitt has served as Administrator of the Environmental Protection Agency (EPA) and is a former Governor of Utah

• At hearings, Mr. Leavitt noted his expectation that implementation of the Medicare Modernization Act, and specifically the Medicare prescription drug benefit, would be the “main event at HHS” in 2005

• www.aamc.org/advocacy/library/washhigh