American Nephrology Nurses Association Written Testimony to the Senate Labor-Health and Human Services Appropriations Subcommittee Regarding Fiscal Year 2007 Funding Submitted by: JoAnne E. Gilmore, BSN RN CNN, President May 1, 2006 Organization Submitting Testimony: American Nephrology Nurses Association Subcommittee to Which Testimony is being submitted: Senate Labor-Health and Human Services Appropriations Subcommittee Department/Agency the testimony is addressing: Department of Health and Human Services National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) Health Resources and Services Administration Title VIII Nursing Workforce Programs The American Nephrology Nurses Association (ANNA) appreciates the opportunity to submit written comments for the record regarding Fiscal Year (FY) 2007 funding to address the challenges that kidney disease and the nursing shortage are posing to the nation. ANNA exists to advance nephrology nursing practice and positively influence outcomes for patients with kidney or other disease processes requiring replacement therapies through advocacy, scholarship, and excellence. ANNA consists of more than 12,000 registered nurses and other health care professionals with varying experience and expertise in such areas as hemodialysis, peritoneal dialysis, conservative management, continuous renal replacement therapies, chronic kidney disease, and renal transplantation. As part of our mission, we educate health professionals, the public, and policymakers to increase public awareness and understanding of the unique health care needs and challenges people with kidney disease face. Moreover, ANNA maintains a strong commitment to securing public policies and programs that help secure better treatments and care for individuals with kidney disease. ANNA specifically seeks to advance public and private efforts to improve treatment of kidney disease, reduce and prevent the onset of end stage renal disease (ESRD), and ensure that all people with kidney disease have access to the medical care and treatment options they need to live the highest quality of life possible. To that end, ANNA respectfully requests that Congress reject the Presidents proposed $11 million cut in funding for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and instead support increased funding for diabetes and kidney disease research to find better treatments, preventive interventions, and develop a cure. NIDDK conducts and supports research on most of the more serious diseases affecting public health. The Institute supports much of the clinical research on the diseases of internal medicine and related subspecialty fields, as well as many basic science disciplines. Additional FY 2007 funding for NIDDK will help advance our nations understanding of the risk factors associated with kidney disease, boost efforts to identify ways in which kidney disease can be reduced and prevented, and increase initiatives to improve care and treatment of individuals with chronic kidney disease as well as those with ESRD. The National Institute of Nursing Research (NINR) supports clinical and basic research to establish a scientific basis for the care of individuals across the life span-from management of patients during illness and recovery to the reduction of risks for disease and disability, the promotion of healthy lifestyles, promoting quality of life in those with chronic illness, and care for individuals at the end of life. NINR seeks to understand and ease the symptoms of acute and chronic illness, to prevent or delay the onset of disease or disability or slow its progression, to find effective approaches to achieving and sustaining good health, and to improve the clinical settings in which care is provided. Importantly, NINR research also focuses on the special needs of at-risk and under-served populations, with an emphasis on health disparities, such as those seen among the ESRD population. These efforts are crucial in the creation of scientific advances and their translation into cost-effective health care that does not compromise quality. ANNA is pleased to join with others in the nursing community in advocating a FY 2007 allocation of $150 million for NINR. As you know, the nation is facing a nursing shortage of unprecedented proportion. At the same time the nursing shortage is expected to worsen, the number of people with ESRD needing access to state-of-the art treatment and care is estimated to increase significantly. More than 350,000 Americans have ESRD which gives the U.S. the highest incidence rate. As the population continues to grow and age and medical services advance, the need for nurses will continue to increase. A report issued by the U.S. Health Resources and Services Administration (HRSA), Projected Supply, Demand, and Shortages of Registered Nurses: 2000-2020, predicted that the nursing shortage is expected to grow to 29 percent by 2020, compared to a seven percent shortage in 2005. Nurses are crucial to the health of our nation and those with ESRD. According to the U.S. Department of Health and Human Services (HHS), the nursing workforce programs housed at HRSA will support the recruitment, education, and retention of an estimated 36,750 nurses and nursing students and approximately 956 new loan repayments and scholarships among other activities. With additional funding in FY 2007, the HRSA nursing workforce programs would have more sufficient resources to bolster the nations nursing workforce at a rate necessary to help stem the nursing shortage tide. To address this current and growing challenge in the health care delivery system, ANNA urges Congress to support the nursing communitys request of $175 million for the HRSA nursing workforce programs. Moreover, please note that ANNA supports the written testimony submitted by the Americans for Nursing Shortage Relief (ANSR) Alliance and respectfully requests your full and fair consideration of the funding allocations and issues outlined by ANSR. Please know that we understand that Congress has limited resources to allocate. However, we are concerned that without adequate funding for research and the nations nursing workforce, the nation will falter in its efforts to diminish suffering from kidney disease and to provide quality nursing care to all in need. On behalf of ANNAs Board of Directors and the hundreds of thousands of individuals with kidney disease to whom we provide care, thank you for this opportunity to submit written testimony regarding the FY 2007 funding levels necessary to ensure that our nation adequately supports kidney disease research and the nations nursing workforce. Please feel free to contact us at any time; we are happy to be a resource to Subcommittee members and your staff.