May 25, 2006
Labor, Health and Human Services, and Education Subcommittee
Appropriations Committee
United States House of Representatives* / Senate**
Washington, DC 20515/20510
Dear Representative* / Senator**:
The nursing organizations listed below are writing to respectfully request your support for a funding level of $175 million in fiscal year (FY) 2007 for the Nursing Workforce Development (Title VIII) programs at the Health Resources and Services Administration (HRSA). With an increasing number of people needing high quality health care coupled with an insufficient number of nurses and nursing faculty, our nation could quickly face a health care crisis of serious proportion with limited access to quality care, particularly in traditionally underserved areas.
Nurses represent the largest group of health care providers who will be called on to respond to an emergency, disaster, or mass-casualty event and the nursing shortage endangers the Nations preparedness efforts for these events. Additionally, the Government Accountability Office (GAO) reports that nursing shortages are complicating efforts at the state and local level to implement terrorism preparedness efforts. Nurses also are essential to efforts to treat U.S. military personnel and to prepare for and respond to domestic threats. There are currently more than 19,000 RNs providing care through the military reserves.
Demand for nursing services is expected to greatly accelerate beginning in 2010 as the leading edge of 77 million baby boomers turn 65. Over the next 15 years, the number of Medicare beneficiaries is estimated to double while more than 1.1 million nursing positions will go unfilled. A study in the New England Journal of Medicine found that nursing shortages in hospitals are associated with a higher risk of complications such as urinary tract infections and pneumonia, longer hospital stays, and even patient death. There will not be enough nurses to care for a growing population of people in need and patient health and well-being could suffer without an adequate supply of nurses.
HRSA projects that, if recent trends continue, the number of RNs leaving the workforce will outpace those entering the profession by 2016. In FY 2005, HRSA was forced to turn away 82 percent of the applicants for the Nurse Education Loan Repayment Program and more than 98 percent of the applicants for the Nursing Scholarship Program due to lack of adequate funding. Additionally, the Department of Labor reports that Americas demand for RNs will grow 29 percent between 2004 and 2014. The National Center on Healthcare Workforce Analysis (NCHWA) also estimates that the U.S. needs to graduate approximately 90 percent more nurses than it did in 2000 to meet projected growth in the demand for RNs in 2020.
The faculty shortage is the primary barrier to increasing enrollments, according to the American Association of Colleges of Nursing (AACN). As a result, at least 37,514 qualified applicants to entry-level baccalaureate programs were turned away from schools of nursing in 2005 based on responses from 564 schools. Some of these qualified students are being placed on waiting lists that may be as long as two years or more, however many are opting for other career choices. Additionally, in a survey of the 2004-2005 academic year conducted by the National League for Nursing (NLN), an estimated 147,000 qualified applications were turned away from nursing programs at all degree levels owing in large part to the lack of faculty necessary to teach this number of additional students. This number represents a 17.6 percent increase from last years figures. The number of full-time nursing faculty required to fill the nursing gap is approximately 40,000. Currently, there are less than 20,000 full-time nursing faculty in the system. The nurse faculty shortage is only expected to worsen with time. Faculty age continues to climb, averaging 52 years in 2005, and significant numbers of faculty are expected to retire in the coming years with insufficient numbers of candidates in the pipeline to take their places.
To that end, the organizations listed below advocate $175 million in FY 2007 to implement and support the Nursing Workforce Development Programs at HRSA. With additional funding, these important programs will be able to continue to address the multiple factors contributing to the nationwide nursing shortage, including the shortage of faculty a principal factor contributing to the current shortage. We appreciate that our Nation faces many challenges and that Congress has limited resources with which to address these challenges. While we acknowledge that this request falls short of meeting the current and future needs for nurses and nursing faculty, we have serious concerns that without increased funding to strengthen the nations nursing workforce we will be unable to ensure that people have access to the quality, comprehensive health care they need and deserve.
Sincerely,
Academy of Medical-Surgical Nurses
American Academy of Ambulatory Care Nursing
American Association of Colleges of Nursing
American Association of Critical Care Nurses
American Association of Nurse Anesthetists
American Association of Occupational Health Nurses
American College of Nurse Practitioners
American Nephrology Nurses Association
American Nurses Association
American Organization of Nurse Executives
American Psychosocial Oncology Society
American Radiological Nurses Association
American Society of PeriAnesthesia Nurses
American Society of Plastic Surgical Nurses
Association of periOperative Registered Nurses
Association of Rehabilitation Nurses
Association of State and Territorial Directors of Nursing
Association of Womens Health, Obstetric and Neonatal Nurses
Dermatology Nurses' Association
Developmental Disabilities Nurses Association
Emergency Nurses Association
Infusion Nurses Society
National Association of Clinical Nurse Specialists
National Association of Orthopedic Nurses
National Association of Pediatric Nurse Practitioners
National Association of School Nurses
National Black Nurses Association
National Council of State Boards of Nursing
National Gerontological Nursing Organization
National League for Nursing
National Nursing Centers Consortium
National Organization of Nurse Practitioner Faculties
National Student Nurses Association
Public Health Nursing Section of the American Public Health Association
Oncology Nursing Society
Society of Gastroenterology Nurses and Associates
Society for Urologic Nurses and Associates
Society for Vascular Nursing
Wound Ostomy and Continence Nurses Society
*Letter was sent to the following Representatives:
Rosa DeLauro (3rd CT)
Kay Granger (12th TX)
Steny Hoyer (5th MD)
Ernest Istook (5th OK)
Jesse Jackson (2nd IL)
Patrick Kennedy (1st RI)
Nita Lowey (18th NY)
Anne Northup (3rd KY)
David Obey (7th WI)
John Peterson (5th PA)
Ralph Regula (16th OH)
Lucille Roybal-Allard (34th CA)
Don Sherwood (10th PA)
Michael Simpson (2nd ID)
James Walsh (25th NY)
Dave Weldon (15th FL)
Roger Wicker (1st MS)
**Letter was sent to the following Senators:
Thad Cochran (MS)
Larry Craig (ID)
Mike DeWine (OH)
Richard Durbin (IL)
Judd Gregg (NH)
Tom Harkin (IA)
Kay Bailey Hutchison (TX)
Daniel Inouye (HI)
Herb Kohl (WI)
Mary Landrieu (LA)
Patty Murray (WA)
Harry Reid (NV)
Richard Shelby (AL)
Arlen Specter (PA)
Ted Stevens (AK)