Letter from ANNA and other organizations to the Senate Labor-Health and Human Services Appropriations Subcommittee regarding funding for the HRSA nursing workforce programs in FY 2007

July 14, 2006

The Honorable Arlen Specter

Chairman, Subcommittee on Labor, Health and Human Services, and Education

Committee on Appropriations

United States Senate

Washington, DC 20510

The Honorable Tom Harkin

Ranking Member, Subcommittee on Labor, Health and Human Services, and Education

Committee on Appropriations

United States Senate

Washington, DC 20510

Dear Chairman Specter and Ranking Member Harkin:

The undersigned organizations urge you to make a real investment in nursing workforce development a priority in the FY 2007 Labor, Health and Human Services, and Education Appropriations Act. Specifically, we ask you to provide at least $175 million in funding for the Nursing Workforce Development Programs (Title VIII of the Public Health Service Act). The Title VIII programs are the primary source of federal support for nursing recruitment, education, and retention. This modest increase of $25 million has been supported by 52 Senators.

Nurses are the primary source of care and support for patients at the most vulnerable points in their lives. Nearly every person's health care experience involves a Registered Nurse (RN). As a result, a sufficient supply of nurses is critical to providing our nation’s population with quality health care. Our nation has struggled with a shortage of RNs since the late 1990s. This shortage impacts the daily operations of our hospitals, nursing facilities, home health agencies, community health clinics, assisted living residences, and public health departments.

Recent studies show that the shortage is not abating. The Department of Labor reported in the Occupational Outlook Quarterly (Winter 2005-06) that America’s demand for RNs will grow 29% between 2004 and 2014. During this time period, we will need to produce 1.2 million RNs, to accommodate growing patient needs and to replace retiring nurses. The American College of Healthcare Executives reported in 2005 that 85% of hospitals were experiencing a nursing shortage. Our community health centers are struggling with a 10% vacancy rate for RNs and a 9% vacancy rate of nurse practitioners.

Current funding levels fail to meet the growing need for nurses. In fiscal year 2005, the Health Resources and Services Administration (HRSA) was forced to turn away 82% of the applicants for the Nurse Education Loan Repayment Program (NELRP), and 98% of the applicants for the Nursing Scholarship program due to lack of adequate funding. These much-needed programs are used to direct RNs into areas with the greatest need – including departments of public health, community health centers, home health agencies, nursing homes, and disproportionate share hospitals.

Nurses are also the cornerstone of pandemic flu and bioterrorism preparedness and response. In the event of a pandemic or a bioterrorist attack, nurses are needed to evaluate patients, administer vaccines and medications, perform disease surveillance, and train non-licensed staff. The GAO reported in 2003 that state and local health officials in many states cited the nursing shortage as an impediment to their bioterrorism preparedness efforts (GAO-03-373).

The nursing shortage is also stressing military health care delivery. The Army, Navy, and Air Force are offering new lucrative RN recruitment packages that include large sign-on bonuses, generous scholarships, and loan forgiveness packages. Yet, neither the Army nor the Air Force has met their active service nurse recruitment goals since the 1990s. Last year, Army leaders warned the Senate Appropriations Committee that they were experiencing a 30% shortage of certified registered nurse anesthetists. In 2004, the Navy Nurse Corps recruitment fell 32% below target. This ongoing nurse shortage is creating real concerns about the ability to deliver needed health care to today’s military.

Therefore, this shortage impacts our very strength as a nation. We urge you to address this crisis by providing at least $175 million in funding for Title VIII Nursing Workforce Development Programs.


American Association of Colleges of Nursing

American Health Care Association

American Hospital Association

American Nephrology Nurses' Association

American Nurses Association

American Organization of Nurse Executives

Catholic Health Association

Federation of American Hospitals

Joint Commission on Accreditation of Healthcare Organizations

National Center for Assisted Living

Oncology Nursing Society



VHA Inc.

Visiting Nurse Associations of America