Written Testimony to House Appropriations Subcommittee
March 23rd, 2023
Testimony of the Nursing Community Coalition
Prepared for the U.S. House Appropriations Subcommittee on Labor, Health and Human Services, and Education, and Related Agencies
U.S. Department of Health and Human Services
Health Resources and Services Administration (HRSA) & National Institutes of Health (NIH)
Submitted by Rachel Stevenson, Executive Director of the Nursing Community Coalition
As the nation evaluates lessons learned from COVID-19, we recognize how crucial federal investments for the nursing workforce and the nursing pipeline are to our patients and the health of our nation. Given these realities, the Nursing Community Coalition (NCC) respectfully requests that Congress continues robust and bold investments in nursing education, workforce, and research in Fiscal Year (FY) 2024 by supporting at least $530 million for the Nursing Workforce Development programs (authorized under Title VIII of the Public Health Service Act [42 U.S.C. 296 et seq.] and administered by HRSA), and at least $210 million for the National Institute of Nursing Research (NINR), one of the 27 Institutes and Centers within NIH.
The Nursing Community Coalition is comprised of 63 national nursing organizations who work together to advance health care issues that impact nursing education, research, practice, and regulation.
Collectively, the NCC represents Registered Nurses (RNs), Advanced Practice Registered Nurses (APRNs),1 nurse leaders, boards of nursing, students, faculty, and scientists, as well as other nurses with advanced degrees. As the largest segment of the health care profession,2 nursing is involved at every point of care, which was further exemplified during the COVID-19 pandemic. Together, we reiterate the bold request for increased funding for Title VIII Nursing Workforce Development programs and NINR, especially during these unprecedented times.
Through the Nursing Lens: Providing Care to All Americans
As we continue to confront today’s health care challenges and plan for tomorrow, increased federal resources for our nation’s current and future nurses are even more imperative. As the largest dedicated funding for nursing, Title VIII programs are instrumental in bolstering and sustaining the nation’s diverse nursing pipeline by addressing all aspects of nursing workforce demand. The Bureau of Labor Statistics (BLS) projected that by 2031 demand for RNs would increase 6%, illustrating an employment change of 195,400 nurses3 and demand for most APRNs is expected to grow by 40%.4
The need for nurses and APRNs is not only outlined by BLS, but can be seen in communities across the nation, including rural and underserved areas. In fact, the American Association of Critical-Care Nurses outlined, “92% of nurses surveyed said they believe the pandemic has depleted nurses at their hospitals and, as a result, their careers will be shorter than they intended.”5
Further, the American Nurses Foundation third COVID-19 impact study found that 19% of nurses said they intend to leave their position in the next six months, and 27% are considering leaving.6
If that was not enough, “more than one-fifth of all nurses reported they plan to retire from nursing over the next 5 years.”7
Funding for Title VIII is essential as these programs connect patients with high-quality nursing care in community health centers, hospitals, long-term care facilities, local and state health departments, schools, workplaces, and patients’ homes. Each program under Title VIII is unique and plays an important role in supporting our nursing workforce. For example, in Academic Year 2021-2022, the Advanced Nursing Education programs, which help APRN students and nurses to practice on the frontlines and in rural and underserved areas throughout the country, supported more than 8,800 students, many of whom were trained in medically underserved areas and primary care settings.8 Further, as we work to create a more equitable health care system, a diverse nursing workforce is imperative. The Nursing Workforce Diversity program helped support more than 10,900 nursing students from racial and ethnic minorities who are underrepresented in the profession to become nurses and APRNs.9
Together, Title VIII Nursing Workforce Development programs serve a vital need and help to ensure that we have a robust nursing workforce that is prepared to respond to public health threats and ensure the health and safety of all Americans. With more than four and half million nurses throughout the country,10 we strongly urge historic support for these programs in FY 2024. Therefore, the Nursing Community Coalition respectfully requests at least $530 million for the Title VIII Nursing Workforce Development programs in FY 2024.
Improving Patient Care Through Scientific Research and Innovation:
For more than thirty years, scientific endeavors funded at the National Institute of Nursing Research (NINR) have been essential to advancing the health of individuals, families, and communities.
NINR’s research is aimed at reducing the impact of social determinants of health and creating a more equitable health care system by promoting patient-centered care across the life continuum. The translational research by our nation’s nurses and scientists is essential to developing new evidence-based practices to care for all patients. It is imperative that we continue to support the necessary scientific research, which is why the Nursing Community Coalition respectfully requests at least $210 million for NINR in FY 2024.
Now, more than ever, it is vital that we have the resources to ensure our nursing workforce is ready to address the health care needs of the nation. Investing in Title VIII Nursing Workforce Development programs and NINR are essential to meeting that need. By providing bold funding for Title VIII and NINR, Congress can continue to reinforce and strengthen the foundational care nurses provide daily in communities across the country. Thank you for your support of these crucial programs.
61 Members of the Nursing Community Coalition Submitting this Testimony
Academy of Medical-Surgical Nurses
Academy of Neonatal Nursing
American Academy of Ambulatory Care Nursing
American Academy of Emergency Nurse Practitioners
American Academy of Nursing
American Association of Colleges of Nursing
American Association of Critical-Care Nurses
American Association of Heart Failure Nurses
American Association of Neuroscience Nurses
American Association of Nurse Anesthesiology
American Association of Nurse Practitioners
American Association of Post-Acute Care Nursing
American College of Nurse-Midwives
American Nephrology Nurses Association
American Nurses Association
American Nursing Informatics Association
American Organization for Nursing Leadership
American Pediatric Surgical Nurses Association, Inc.
American Public Health Association, Public Health Nursing Section
American Psychiatric Nurses Association
American Society for Pain Management Nursing
American Society of PeriAnesthesia Nurses
Association for Radiologic and Imaging Nursing
Association of Community Health Nursing Educators
Association of Nurses in AIDS Care
Association of Pediatric Hematology/Oncology Nurses
Association of periOperative Registered Nurses
Association of Public Health Nurses
Association of Rehabilitation Nurses
Association of Veterans Affairs Nurse Anesthetists
Commissioned Officers Association of the U.S. Public Health Service
Dermatology Nurses’ Association
Emergency Nurses Association
Friends of the National Institute of Nursing Research
Gerontological Advanced Practice Nurses Association
Hospice and Palliative Nurses Association
Infusion Nurses Society
International Association of Forensic Nurses
International Society of Psychiatric-Mental Health Nurses
National Association of Clinical Nurse Specialists
National Association of Hispanic Nurses
National Association of Neonatal Nurse Practitioners
National Association of Neonatal Nurses
National Association of Nurse Practitioners in Women’s Health
National Association of Pediatric Nurse Practitioners
National Association of School Nurses
National Black Nurses Association
National Council of State Boards of Nursing
National Forum of State Nursing Workforce Centers
National Hartford Center of Gerontological Nursing Excellence
National League for Nursing
National Nurse-Led Care Consortium
National Organization of Nurse Practitioner Faculties
Nurses Organization of Veterans Affairs
Oncology Nursing Society
Organization for Associate Degree Nursing
Pediatric Endocrinology Nursing Society
Preventive Cardiovascular Nurses Association
Society of Pediatric Nurses
Society of Urologic Nurses and Associates
Wound, Ostomy, and Continence Nurses Society
1 APRNs include certified nurse-midwives (CNMs), certified registered nurse anesthetists (CRNAs), clinical nurse specialists (CNSs) and nurse practitioners (NPs).
2 United States Census Bureau. (2021) Who are our Health Care Workers? Retrieved from: https://www.census.gov/library/stories/2021/04/who-are-our-health-care-workers.html
3 U.S. Bureau of Labor Statistics. (2022). Occupational Outlook Handbook- Registered Nurses. Retrieved from: https://www.bls.gov/ooh/healthcare/registered-nurses.htm
4 U.S. Bureau of Labor Statistics. (2022). Occupational Outlook Handbook- Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners. Retrieved from: https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm
5 American Association of Critical-Care Nurses. (2021). Hear Us Out Campaign. Retrieved from: https://www.aacn.org/newsroom/hear-us-out-campaign-reports-nurses-covid-19-reality
6 American Nurses Foundation. (2023). Three-Year Annual Assessment Survey: Nurses Needed Increased Support from their Employer. Retrieved from: https://www.nursingworld.org/~48fb88/contentassets/23d4f79cea6b4f67ae24714de11783e9/anfimpact-assessment-third-year_v5.pdf
7 National Council of State Boards of Nursing and the National Forum of State Nursing Workforce Centers (2021) The 2020 National Nursing Workforce Survey. Retrieved from: https://www.journalofnursingregulation.com/article/S2155-8256(21)00027-2/fulltext
8 Health Resources and Services Administration. Fiscal Year 2024 Budget Justification. Pages 153-156. Retrieved from: https://www.hrsa.gov/sites/default/files/hrsa/about/budget/budget-justification-fy2024.pdf
9 Health Resources and Services Administration. Fiscal Year 2024 Budget Justification. Pages 157-160. Retrieved from: https://www.hrsa.gov/sites/default/files/hrsa/about/budget/budget-justification-fy2024.pdf
10 National Council of State Boards of Nursing. (2023). Active RN Licenses: A profile of nursing licensure in the U.S. as of March 23, 2023. Retrieved from: https://www.ncsbn.org/6161.htm