Bureau of Health Professions, HRSA

1. Division of NursingBureau of Health ProfessionsHealth Resources and Services Administration (HRSA)Overview: Title VIII of the Public Health Services ActNursing Workforce Development Julie Sochalski, Director, Division of NursingU.S. Department of Health and Human ServicesHealth Resources and Services AdministrationBureau of Health Professions

2. 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

3. Division of NursingBureau 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.

4. History of Title VIII of thePublic Health Services (PHS) Act • 1963-Surgeon General’s report , Toward Quality in Nursing, Needs and Goals1  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. 2Lyndon 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.

5. 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)

6. Division of NursingBureau of Health Professions, HRSA 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

7. Title VIII Grant ProgramsAdvanced Nursing Education Program Provides program development and traineeship grants to schools of nursing for advanced nursing education. Nurse Education, Practice, Quality & Retention Program Support projects that strengthen the nursing workforce and improve nurse retention and quality of care by expanding the nursing pipeline, promoting career mobility, providing continuing education, and supporting retention activities. Nursing Workforce Diversity Supports projects that increaseopportunities for persons from disadvantaged backgrounds including racial and ethnic minorities to pursue nursing education. Nurse Scholarship Program & Nursing Education Loan Repayment Program Provides financial support to current and newly graduating pre-licensure and graduate-level nursing students. Nurse Faculty Loan Program Provides support to schools of nursing for loans to students enrolled in programs preparing nursing faculty to increase the number of qualified nursing faculty. Comprehensive Geriatric Education Program Provides program development and training support to schools of nursing to enhance geriatric education.

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

9. 18.6 Million Americans Work in Health CareHealth Sector Employment(13.7M):4.1 million non-health professionals In health sector1 Between Health Sector Employment and Health Professionals: 9.6 million health professionals inhealth sector1Health Professionals(14.5M): 4.9 million health professionals outside the health sector1All of this: 18.6 million people work in health care1BLS defines the health sector to include ambulatory health care services, hospitals, nursing and residential care facilities, and social assistance. Source: U.S. Bureau of Labor Statistics (BLS), “Occupational Projections: 2008-2018”; analysis performed by The Albany Center for Health Workforce Studies and published in: “Health Care Employment Projections: An Analysis of Bureau of Labor Statistics Occupational Projections, 2008-2018.” Health Sector Employment (13.7M) Health Professionals (14.5M) 18.6 million people work in health care 4.1 million non-health professionals in health sector1 9.6 million health professionals in health sector1 4.9 million health professionals outside the health sector1 1BLS defines the health sector to include ambulatory health care services, hospitals, nursing and residential care facilities, and social assistance. Source: U.S. Bureau of Labor Statistics (BLS), “Occupational Projections: 2008-2018”; analysis performed by The Albany Center for Health Workforce Studies and published in: “Health Care Employment Projections: An Analysis of Bureau of Labor Statistics Occupational Projections, 2008-2018.”

10. Population growth: U.S. population to grow by around 30 million in next decade1 Medical advances and successes Increased incidence of chronic diseases Insurance coverage expansion1 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). Drivers of Future Demands for Services

11. 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 HRSA Strategic Priorities and Division of Nursing

12. 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 National Center for Health Workforce Analysis

13. Recent Trends and Implicationsfor 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

14. 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 Contact Information