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NACNEP is a legislatively mandated body
that provides advice and recommendations
to the Secretary of Health and Human Services
and the Congress on Federal policy matters
specifically related to nursing. A national
advisory council for nursing was initially
established under legislation in 1964
to provide advice in connection with the
administration of the funding for nursing
education under Title VIII of the Public
Health Service Act. Much of the work in
the earlier years of the council was devoted
to reviewing the proposals for funding
under the various programs and advising
on the policies and regulations for the
Nurse Training Act.
In the 1992 legislation reauthorizing
Title VIII (P.L. 102-408), the council
was renamed the National Advisory Council
on Nurse Education and Practice in recognition
of the need to look beyond education to
practice. NACNEP’s activities continued
to evolve over the 37 years of its existence.
The 100th meeting of the council occurred
in November 1999. In recognition, the
Secretary of Health and Human Services
addressed the council and a reception
was held in her office. NACNEP, over the
years of its existence, increasingly became
involved in broader workforce issues and
advising on how the Federal government
could contribute to advancing the health
care of the United States population through
the development of an adequate, qualified
registered nurse workforce.
The legislation reauthorizing Title
VIII enacted in November 1998 (P.L. 105-392,
the Nurse Education and Improvement Act
of 1998) continued NACNEP with these two
Title VIII responsibilities:
- provide advice and recommendations
to the Secretary and Congress concerning
policy matters arising in the administration
of this title, including the range of
issues relating to the nurse workforce,
education, and practice improvement;
and
- provide advice and recommendations
to the Secretary and Congress in the
preparation of general regulations with
respect to policy matters arising in
the administration of this title, including
the range of issues relating to nurse
supply, education and practice improvement.
The legislative requirements also call
for NACNEP to provide its first report
on its activities and findings and recommendations
related to these activities to the Secretary
and the Congress 3 years after the date
of enactment and annually, thereafter.
NACNEP examined its current set of responsibilities
and, in February 2000, established a Strategic
Plan with goals and objectives to guide
its responses to existing and emerging
workforce issues related to distribution,
diversity, quality and safety, and access
to nursing education and practice. The
goals took into account the need to examine
both the quality and the quantity of the
nursing workforce including its educational
underpinning and the need to support the
furtherance of interdisciplinary education
and practice through collaborative activities
with other disciplines.
NACNEP undertook four major activities
in pursuit of its goals:
- NACNEP, in a communication to the
Medicare Payment Advisory Commission
dated August 11, 2000, called for a
redirection of the Medicare funds for
nursing education from supporting hospital-based
diploma programs. The council recommended
that the funds be used to provide support
for baccalaureate and higher degree
nursing education programs pointing
out that these educational programs
prepare the nurses who are best qualified
to care for the elderly.
- NACNEP examined the substantial disparity
between the diversity of the RN population
and that of the population as a whole.
Its report to the Secretary and the
Congress, entitled A
National Agenda for Nursing Workforce:
Racial/Ethnic Diversity (2000),
points out that a culturally diverse
workforce is essential to meeting the
health care needs of the population.
The report is a call to action containing
a series of policy goals and actions
for the many organizations and agencies,
both public and private, necessary to
remedy the significant underrepresentation
of racial/ethnic minorities in the RN
workforce.
- NACNEP, in partnership with the Council
on Graduate Medical Education (COGME),
examined collaborative approaches to
reducing medical errors and enhancing
patient safety. A subgroup of members
from the two councils met to develop
the plans for a joint meeting held on
September 13-14, 2000 at which the councils
heard from experts on interdisciplinary
nursing and medical education and practice
and patient safety. The report to the
Secretary and the Congress, Collaborative
Education to Ensure Patient Safety
contains the presentations from the
meeting, an extensive annotated bibliography
on nurse-physician collaboration in
practice and the two councils’ joint
recommendations for actions to foster
interdisciplinary education and safe
practice in the management of health
care and the treatment of the population.
- NACNEP, most recently, addressed
the nationwide concerns of a current
and future nursing shortage. The last
two meetings of the council were devoted
to the shortage issue. The first meeting
focused on national and regional experts
providing their data and evaluations
of the current and future state of the
availability of nursing resources.
At the second meeting, 16 national nursing
organizations presented their perspectives
of the current situation and their suggested
solutions (see Invited Comments from National
Nursing Organizations Before the NACNEP,
April 26, 2001). These activities resulted
in the NACNEP policy document, Nursing:
A Strategic Asset for the Health of the
Nation. The document stresses the
immediacy and critical importance of the
shortage issue. It provides recommendations
stating the council’s strategies to help
reverse this severe and complex evolving
nursing shortage, including approaches
for strengthening the effect of the provisions
under the Title VIII legislation.
Other on- going and emerging activities
of NACNEP include the following:
- NACNEP during the initial developmental
stages of the funding methodology called
for in the Title VIII legislation held
discussions with the contractor for
the first phase of the project at its
November 1999 and April 2000 meetings.
It continues to be represented in activities
related to the funding methodology for
Title VIII. The latest reauthorization
of Title VIII (P.L. 105-392) allows
for flexibility in the spending of the
overall appropriations among and within
the three major parts, advanced education,
increasing nursing workforce diversity
and basic nurse education and practice.
Before this funding flexibility can
take place, the law requires that a
funding methodology be developed with
consultation from the field of nursing.
A Funding Allocation Consultation Panel
of representatives from nursing organizations
provided input into the development
process. A NACNEP representative participated
on this Panel. During the second phase
of the process, NACNEP will continue
to have representation on an expert
panel that will consult with the contractor
developing the implementation of the
funding allocation methodologies that
were recommended.
- NACNEP is partnering with COGME to
advance their work on patient safety.
The Institute of Medicine (IOM) Committee
on Quality of Health Care in America,
in its report entitled Crossing the
Quality Chasm: A New Health System for
the 21st Century, called for the convening
of a multidisciplinary summit of leaders
from the health professions to discuss
and develop strategies for restructuring
clinical education and assessing the
implications of these changes for credentialing,
funding and educational programs. The
two councils are collaborating to convene
a multidisciplinary summit of leaders
from medicine, nursing and pharmacy.
Representatives from IOM, the Agency
for Health Care Research and Quality,
the Department of Veterans Affairs, the
Food and Drug Administration, the National
Advisory Committee on Interdisciplinary,
Community-based Linkages and the Advisory
Committee on Training in Primary Care
Medicine and Dentistry have expressed
interest in participating with NACNEP
and COGME in this endeavor. The ongoing
planning is looking toward holding the
summit in June 2002. |
