Friday, February 27th 2004

The Honorable Jim Nussle
Budget Committee
US House of Representatives
Washington, D.C. 20515

Dear Chairman Nussle:

The organizations listed below, representing the breadth and depth of the nation's health care delivery system, are contacting you to urge you to make funding for Nursing Workforce Development programs (Title VIII, Public Health Service Act) a priority in the FY 2005 budget resolution. Specifically, we ask you to increase the Function 550 budget authority to allow for a $63 million increase in FY 2005 appropriations for the nurse education programs of the Health Resources and Services Administration.

Our nation is struggling with a growing shortage of registered nurses (RNs) that affects our hospitals, nursing facilities, assisted living residences, home health agencies, and public health clinics on a daily basis. Because RNs are the largest health care delivery workforce in the nation, this burgeoning shortage threatens the very fabric of our health care system.

Health care providers across the country are adversely affected by the nursing shortage in terms of their ability to provide the high quality and safe care that our citizen's both deserve and expect. This growing shortage is caused in part by a lack of young people entering the profession, and an aging nursing workforce. This problem will peak just as the 'baby boomer' generation begins to require more health care.

On February 11, 2004, the Bureau of Labor Statistics reported that registered nursing will have the greatest job growth of all US professions in the time period spanning 2002 - 2012. During this ten-year period, health care facilities will need to fill more than 1.1 million RN job openings in order to accommodate growing patient needs and to replace retiring nurses. A recent report from the Health Resources and Services Administration projects that, absent aggressive intervention, the RN workforce will fall 29 percent below requirements by the year 2020.

The nursing shortage is already directly impacting patient care. Recent studies have reported 126,000 hospital RN vacancies and 13,900 staff RN vacancies in nursing homes. A recent survey of hospitals across the nation concluded nursing shortages are causing emergency department overcrowding, emergency department diversions, increased wait times for surgery, discontinued patient care programs or reduced service hours, delayed discharges, and canceled surgeries.

This burgeoning nursing shortage has effects well beyond every day health care. Nurses are integral in everything from ensuring adequate terrorism preparedness, to veteran's health delivery, to providing services during disaster response. In addition, the activation of military reserves is drawing nurses out of the domestic labor market (there are approximately 19,000 RNs in the military reserves). Therefore, this shortage threatens our very strength as a nation.

The Nurse Reinvestment Act (P.L.107-205), a triumph of bipartisan and bicameral efforts, represents an important step toward addressing this growing crisis. It holds the promise of attracting new recruits into the nursing profession, while improving the work environment to maintain experienced nurses in patient care. However, a significant investment for the programs authorized by the Nurse Reinvestment Act is necessary to ensure that an adequate and well-educated supply of nurses is available to meet our growing health care needs.

Your support for an increased budget authority for nursing workforce development is vital to maintaining and improving the health and security of our nation.


American Association of Colleges of Nursing
American Health Care Association
American Hospital Association
American Nurses Association
American Organization of Nurse Executives
Catholic Health Association of the United States
Federation of American Hospitals
Gentiva Health Services
Joint Commission on Accreditation of Healthcare Organizations
National Center for Assisted Living
VHA Inc.
Visiting Nurse Associations of America


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