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Wrapping Your Head around Health Reform. Kathleen A. Ream Director, Government Affairs. October 1, 2010. SETTING THE STAGE. March 23, 2010 - Patient Protection and Affordable Care Act (PPACA), P.L. 111-148 September 23, 2010 - Patient’s Bill of Rights.

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Wrapping Your Head around Health Reform


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wrapping your head around health reform

Wrapping Your Head around Health Reform

Kathleen A. Ream

Director, Government Affairs

October 1, 2010

setting the stage
SETTING THE STAGE
  • March 23, 2010 - Patient Protection and Affordable Care Act (PPACA), P.L. 111-148
  • September 23, 2010 - Patient’s Bill of Rights
implications of health care reform for nursing
IMPLICATIONS OF HEALTH CARE REFORM FOR NURSING
  • Incentives to Educate More Nurses
  • Increases Demand for Highly-Skilled Nurses
  • Quality Incentives
  • Other Practice Opportunities
  • Boards, Commissions, Councils, and Panels
caution
CAUTION!!

PPACA is an authorization bill. Many of its provisions will require appropriated funding.

ppaca reauthorizes title viii nursing workforce development program effective dates fy 2010 2014
PPACA REAUTHORIZES TITLE VIII - NURSING WORKFORCE DEVELOPMENT PROGRAMEffective dates: FY 2010-2014
nurse faculty loan program
NURSE FACULTY LOAN PROGRAM
  • Expands the educational loan repayment amount from $30,000 to $35,500
  • Creates “Eligible Individual Student Loan Repayment” program
  • Increases loan repayment amounts up to $40,000 for master’s & $80,000 for doctoral
  • Funding priority to doctoral students to impact nurse faculty shortage
medicare graduate nursing education demonstration program
Medicare Graduate Nursing Education Demonstration Program
  • Effective January 1, 2012 thru 2015
  • $200 Million for Demo Projects
  • Medicare payments to hospitals for clinical training costs of preparing APRNs – nursing’s equivalent to GME
  • Partnership created among hospitals, accredited schools of nursing, and non-hospital community-based care settings
advanced nursing education grants
ADVANCED NURSING EDUCATION GRANTS
  • Eliminates 10% cap on doctoral programs for AEN grants
  • Allows funds to go directly to students not only to schools
loan repayment and scholarship program
LOAN REPAYMENT AND SCHOLARSHIP PROGRAM
  • Nurse faculty now included as eligible participants
  • For repayment must serve as faculty at an accredited nursing school for two years
nurse education practice retention grants
NURSE EDUCATION, PRACTICE, & RETENTION GRANTS
  • Grant program now titled “Nurse Education and Practice Grants”
  • Nurse Retention gets own section
  • Expands career ladder programs, funding for nursing internships and residency programs in collaboration with accredited schools of nursing
nursing student loan program
NURSING STUDENT LOAN PROGRAM
  • Now includes nursing faculty as eligible participants
  • Increases aggregate amount of student loan from $13,000 to $17,000
  • Increases student loan amounts from $2,500 to $3,500
  • Increases student loan amounts for final two years from $4,000 to $5,200
comprehensive geriatric education
COMPREHENSIVE GERIATRIC EDUCATION
  • PPACA creates a CGE Traineeship that provides funding to students for tuition, books, and stipends
  • No funding has yet been appropriated for FY 2011
workforce diversity grants
WORKFORCE DIVERSITY GRANTS
  • Provides stipends for diploma or AD nurses to enter bridge programs
  • Provides scholarship or stipends for accelerated degree programs, pre-entry preparation, advanced education preparation, and retention activities
additions to title viii
ADDITIONS TO TITLE VIII
  • Two other types of nursing programs are now eligible for Title VIII funding:
    • “Accelerated” BSN or MSN programs
    • “Bridge” BSN or MSN programs
national health service corps
NATIONAL HEALTH SERVICE CORPS
  • Scholarship & Loan Repayment Programs for students in accredited health professions education program in exchange for 2-4 years of service in a health professional shortage area
  • Aimed at FNPs and CNMs
primary care extension program
PRIMARY CARE "EXTENSION" PROGRAM
  • Program will educate providers in primary care, prevention, chronic care management, mental and behavioral health, and evidence-based practice
  • Provision uses the IOM definition of primary care which includes nursing
fnp residency training program
FNP RESIDENCY TRAINING PROGRAM
  • NP Residency program in federally qualified health centers or nurse managed health clinics
  • Awarded health centers need to have at least 3 NP residents in training program
  • Preference given to bi-lingual nurse practitioners
u s public health service track
U.S. PUBLIC HEALTH SERVICE TRACK
  • Began FY 2010
  • Organized to annually graduate at least 250 nursing students
  • Students receive tuition and stipend for no more than 4 years
  • Upon degree completion, awardees serve two years for each year they were supported
pediatric health care workforce
PEDIATRIC HEALTH CARE WORKFORCE
  • Loan repayment program to drive clinicians to provide pediatric health care in underserved areas for 2 years
  • Providers include psychiatric nurses for the Child & Adolescent Behavioral Health provision
  • Up to $35,000 in loans/year will be repaid for a maximum of 3 years
maternal infant early childhood home visiting programs
MATERNAL, INFANT, & EARLY CHILDHOOD HOME VISITING PROGRAMS
  • Creates strong expansion opportunity for Nurse-Family Partnership
  • $1.5 billion mandatory funding over 5 years – FY 2010 thru FY 2014
medicare independence at home demonstration program
MEDICARE INDEPENDENCE AT HOME DEMONSTRATION PROGRAM
  • Payment incentive and service delivery model
  • Utilizes physician and NP directed home-based primary care teams
  • $30 million mandatory funding over 6 years – FY 2010 thru FY 2015
grant program for school based health centers sbhcs
GRANT PROGRAM FOR SCHOOL-BASED HEALTH CENTERS (SBHCS)
  • NPs can direct SBHCs
  • Comprehensive primary health services for medically underserved children & adolescents
  • Available for both building capacity in existing SBHCs and to create new ones
  • $200 Million mandatory funding over 5 years – FY 2010 thru FY 2014
improved medicare payments
IMPROVED MEDICARE PAYMENTS
  • Increases payment for CNMs from 65% to 100%
  • Increases payments to NPs and CNSs by 10% for primary care & health professional shortage areas services
state health care workforce development grants
STATE HEALTH CARE WORKFORCE DEVELOPMENT GRANTS
  • Grant program to create health care workforce development strategies at state & local levels
  • Planning grants for no more than 1 year with largest award no more than $150,000
  • Eligible partnerships must include 2-year & 4-year public institutions of higher education
boards commissions councils panels
BOARDS, COMMISSIONS, COUNCILS, & PANELS
  • Independent Medicare Advisory Board
  • National Health Care Workforce Commission
  • Patient Centered Outcomes Research Institute
  • Advisory Board on Elder Abuse, Neglect and Exploitation
patient s bill of rights 9 23 10
PATIENT’S BILL OF RIGHTS9/23/10
  • No Pre-Existing Condition Exclusions for Children Under Age 19
  • No Arbitrary Rescissions of Insurance Coverage
  • No Lifetime Limits on Coverage
patient s bill of rights cont d
PATIENT’S BILL OF RIGHTSCont’d
  • Restricted Annual Dollar Limits on Coverage
  • Protecting Your Choice of Doctors by removing insurance barriers
  • Removing Insurance Company Barriers to accessing ED Services
resource for future information

RESOURCE FOR FUTURE INFORMATION

NLN’S GOVERNMENT AFFAIRS HOMEPAGE

http://www.nln.org/governmentaffairs/index.htm