About The Issue
Title VIII Nursing Workforce Development programs provide the largest source of federal funding for nursing education, offering financial support for nursing education programs, individual students, and nurses.
Title VIII programs bolster nursing education from entry-level preparation through graduate study. According to HRSA, between FY 2006 and 2012 alone, these programs provided loans, scholarships, and programmatic support to over 450,000 nursing students and nurses. For five decades, these programs have helped build the supply and distribution of qualified nurses in all health care settings. It is imperative that Title VIII programs continue to thrive, as the U.S. Labor Statistic's Employment Projections for 2012-2022 project nurse employment rates to grow by 19 percent, meaning that the nursing workforce will be over 1 million by 2022.
The major grant programs within Title VIII are:
- Advanced Education Nursing – Provides grants to nursing schools, academic health centers and other entities to enhance education and practice for nurses in master's and post-master's programs. These programs prepare nurse practitioners, clinical nurse specialists, nurse midwives, nurse anesthetists, nurse educators, nurse administrators and public health nurses.
- Workforce Diversity Grants – Provides grants to increase opportunities for individuals who are from disadvantaged backgrounds, including students from economically disadvantaged families as well as racial and ethnic minorities underrepresented in the nursing profession.
- Nurse Education, Practice and Retention Grants – Supports schools and nurses at the associate and baccalaureate degree levels. Grants are provided to schools of nursing, academic health centers, nursing centers, state and local governments, and other public or private nonprofit entities. Some grants (such as grants promoting the Magnet Hospital best practices for nursing administration) are also available to health care facilities.
- National Nurse Service Corps – The Nurse Education Loan Repayment Program repays 60 to 85 percent of nursing student loans in return for at least two years of practice in a facility designated as having a critical shortage of nurses. The Nursing Scholarship Program supports students enrolled in nursing school. Upon graduation, scholarship recipients are required to work full time for at least two years in a facility designated as having a critical shortage of nurses.
- Nurse Faculty Loan Program – Establishes loan programs within schools of nursing to support students pursuing master's and doctoral degrees. Upon graduation, loan recipients are required to teach at a school of nursing in exchange for cancellation of up to 85 percent of their educational loans, plus interest, over four years.
- Comprehensive Geriatric Education Grants – Provides grants to train nurses who provide direct care for the elderly, to support geriatric nursing curriculum, to train faculty in geriatrics and to provide continuing education to nurses who provide geriatric care.
Bipartisan Title VIII reauthorization bill introduced in Senate
On July 14, 2016, Senator Jeff Merkley (D-OR) and Senator Richard Burr (R-NC) introduced the Nursing Workforce Reauthorization Act of 2016 in bipartisan fashion.
ANA was instrumental in the introduction of this legislation, which would reauthorize, update, and improve nurse workforce programs under Title VIII, which supports nurses practicing in rural and medically underserved communities, advanced education nursing, diversity grants, National Nurse Service Corp, nurse faculty loan forgiveness, as well as geriatric education.
President Obama’s final budget prompts praise and pause from the American Nurses Association
The American Nurses Association (ANA) recognizes the many critical investments put forth in today's budget proposal and appreciates the President's continued commitment to strengthening our nation's health care system. ANA, however, maintains concerns over the framework’s inadequate support for vital nursing workforce development programs.
The President's budget recommends $229.5 million for Nursing Workforce Development Programs (Title VIII of the Public Health Service Act), representing a continuation of FY 2016 enacted levels. Title VIII provides critical federal grants for nursing schools and organizations to advance their educational programs, promote diversity in the field, repay loans for nursing students who work in facilities with critical shortages, and train geriatric nurses.
Title VIII funding plays a critically important role in recruiting the next generation of nurses, addressing the faculty shortages facing the profession, and ensuring we are building a highly trained workforce that can meet the challenges of a fast-growing and evolving health care system.
Despite concerns about Nursing Workforce Development Program funding, ANA appreciates the Administration's call for critical health care investments in other areas, including:
- $145.912 million for the National Institute of Nursing Research
- NIH would receive $1.8 billion in mandatory funds to support new research as part of a total budget of $33.1 billion for the agency. The proposed $1.8 billion mirrors mandatory spending levels advanced in the House-passed 21st Century Cures bill (H.R. 6), which would provide the National Institutes of Health with $8.75 billion a year over five years, or $1.75 billion a year in mandatory spending.
- $1 billion initiative to address opioid abuse, misuse, and overdose through expanded access to treatment. The proposal includes a pilot program that would allow nurse practitioners and physician assistants to prescribe buprenorphine for opioid use disorder treatment, where allowed by state law.
- 1.8 billion in emergency funding to combat the Zika virus
- "Cancer Moonshot", initiative aimed at better understanding the causes of cancer, developing new prevention strategies, improving early detection, diagnosis, and treatment and modernizing regulatory pathways.
- Increasing access to early intervention mental and behavioral health programs, expanding the behavioral health workforce and supporting suicide prevention.
- $469.7 million for Agency for Healthcare Research and Quality, an increase of $41.2 million from FY16.
While ANA recognizes the budgetary considerations that lie ahead for appropriators in Congress, we believe that bold efforts to cure cancer, stem the opioid epidemic, protect against the Zika virus, expand access to mental health services and other fundamental challenges are worthy investments. Tackling these important initiatives requires a strong, highly trained health workforce. With that in mind, ANA will continue to advocate for appropriate Title VIII funding levels.