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NLN Board of Governors advocate for SAMHSA, Title VII, and Title VIII funding.

Last week the NLN Board of Governors brought its concerns to Capitol Hill. During the meetings with their congressional delegations, board members focused on returning war veterans and their need for mental health and substance abuse disorders health care (MH/SUD) They also advocated for robust funding for Title VIII Nursing Workforce Development Programs and the Health Professions Programs under Title VII of the Public Health Service Act.

Advocating for increased funding in FY 2015 for SAMHSA, board members noted that with one in three adults living with a mental disorder and one in 10 children having a serious mental or emotional disorder, states and communities cannot tolerate further cuts. The unintended consequences of cutbacks are taking a devastating toll especially on our most vulnerable patient populations, including America's servicemen, servicewomen, and their families. More service members than ever are returning home with the invisible wounds of war, ranging from post-traumatic stress disorder (PTSD) to SUD and suicide. Their families struggle as well. Increasingly, service members and their families are seeking behavioral health and primary care services in their communities.

In their visits, when discussing SAMHSA, board members noted that:

* Among the US troops returning from Iraq and Afghanistan, nearly 40 percent of soldiers, a third of the Marines, and half of the National Guard members report symptoms of psychological problems. Thirty-one percent of all Army soldiers and other military personnel who have experienced heavy combat in Iraq and Afghanistan also have at least one mental or psychosocial disorder.

* There are 301 confirmed or suspected soldier suicides in 2010, including those on active duty and reservists or National Guard troops on an inactive status. This compares with 242 in 2009. The Army's current suicide rate is about 22 deaths per 100,000, which is above a civilian rate that has been adjusted to match the demographics of the Army. That rate is 18 per 100,000. Only the Marine Corps has a higher suicide rate--24 per 100,000.

* Suicide is the first leading cause of death for female veterans.

* Sexual victimization is a problem in military populations. In the general US population, lifetime prevalence of sexual assault is 17 percent and 3 percent for women and men, respectively. The rate of sexual victimization among male military members is roughly the same as general population, but for women in the military, rates of sexual victimization are higher with estimates tending to cluster in the 23 to 33 percent range.

During the meetings with their congressional delegations, board members also advocated for increased funding for Title VIII--Nursing Workforce Development Programs and for the Health Professions Programs under Title VII of the Public Health Service Act. Armed with data, the board members noted that:

For Title VIII--Nursing Workforce Development Programs

* The NLN supports a budget of $251 million in FY 2015 for the Nursing Workforce Development Programs.

* Our health care system is integral to the US economy. With a spending level of $2.8 trillion in 2012, it constitutes the largest share of the nation's gross domestic product (GDP), growing from 8.8 percent of GDP in 1980 to 17.2 percent of GDP in 2012. It is virtually the only sector that added jobs to the economy on a net basis since 2001.

* With more than 4.031 million active, licensed RNs in 2013, nurses represent the largest occupation of all health care workers in the United States and provide 85 percent of the health care delivery.

* According to the Bureau of Labor Statistics (BLS), by 2022, total employment of RNs and APRNs will increase by 574,400 jobs. With upcoming RN retirements in the mix, the nation will need to produce 1.13 million new RNs by 2022 to fill those jobs.

The BLS projects that there will need to be 35 percent more faculty members to meet the expected increase in demand for nurses.

For Title VII--Health Professions Programs

* The NLN is supporting an FY 2015 budget of $280 million for Title VII--Health Professions Programs.

* Destabilizing funding for the Title VII programs would reduce education and training support for primary care physicians, nurses, and other health professionals, exacerbating shortages and further straining the nation's already fragile health care system.

* A report by the Institute of Medicine characterized the HRSA health professions programs as an "undervalued asset" and recommended that Congress "invest in programs with proven effectiveness."

* The United States currently has 7,356 geriatricians--one geriatrician for every 2,551 Americans 75 or older. As baby boomers age, this ratio is expected to drop to one geriatrician for every 3,798 older Americans in 2030. Since its inception, the Title VII Geriatric Education Program has trained more than 425,000 health practitioners in more than 27 health disciplines.

For Nurse-Managed Health Clinics

The NLN supports a budget of $20 million for Nurse-Managed Health Clinics (NMHC).

* A shortage of primary care providers exists which will continue to grow over the next decade. With the recent growth of NMHCs, APRNs have demonstrated their flexibility as they practice in both primary care and specialty areas. This shift suggests that professionals' practice can be directed to changing workforce and population needs as the increased use of APRNs holds the potential for improving access, reducing costs for high-value care, and changing patterns of care.

* NMHCs deliver comprehensive primary health care services, disease prevention, and health promotion in medically underserved areas for vulnerable populations. Approximately 58 percent of NMHC patients are either uninsured, Medicaid recipients, or self-pay.
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Title Annotation:DAY ON THE HILL; National League for Nursing and Substance Abuse and Mental Health Services Administration
Publication:Nursing Education Policy Newsletter
Geographic Code:1USA
Date:May 1, 2014
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