On Monday, U.S. Department of Health & Human Services Secretary Kathleen Sebelius announced a program that will help military veterans who have health care experience or training pursue nursing careers. The Veterans’ Bachelor of Science in Nursing Program is expected to provide $3 million before the end of this fiscal year (September 30) to accredited schools of nursing to increase veterans’ enrollment, and provide mentorship and other support services.

“The Veterans’ Bachelor of Science in Nursing Program recognizes the skills, experience and sacrifices of our veterans, while helping to grow our nursing workforce,” Secretary Sebelius said in a news release.  “It helps veterans formalize their skills to get jobs, while strengthening Americans’ access to care.”

The funds will also be used to explore ways to award academic credit for prior military health care experience or training.

Read more about the new federal veterans/nursing program.

President Obama’s Fiscal Year 2014 budget proposal recommends a $20 million increase over previous budget proposals for the Title VIII Nursing Workforce Development Programs, the primary source of federal funding for nursing education.

“With the proposed increase to Title VIII funding, the Obama administration continues to recognize the invaluable contribution that nurses make in the delivery of care and the need to strengthen our primary care system,” American Nurses Association (ANA) President Karen A. Daley, PhD, RN, FAAN, said in a statement.

According to the Center to Champion Nursing in America (CCNA), the $20 million increase will expand the pool of primary care Advanced Practice Registered Nurses through the Advanced Education Nursing Traineeship Program.  If enacted, and if the funding is sustained, the increase will produce an additional 1,800 primary care nurses over five years.

“The President's proposal to train 1,800 more primary care nurse practitioners would provide a much needed shot in the arm to our health care workforce,” said Winifred Quinn, MA, PhD, director of legislation and field operations at CCNA. “These new health professionals are key to boosting consumer access to primary and preventive care, and other innovative delivery system reforms we are counting on to improve quality and hold down costs.”

The ANA also applauded other health care investments in the budget, including funding for community health centers, new mental health programs, health reform implementation, medical research, and more.

Read ANA’s statement about the budget.
Learn more about Title VIII Nursing Workforce Development Programs.

The Health Resources and Services Administration (HRSA) last week announced that the University of Minnesota Academic Health Center will lead its new Coordinating Center for Interprofessional Education and Collaborative Practice. The Center will have a mission to accelerate teamwork and collaboration among nurses, doctors and other health professionals, with a particular focus on medically underserved areas.

“Health care delivered by well-functioning coordinated teams leads to better patient and family outcomes, more efficient health care services, and higher levels of satisfaction among health care providers,” said HRSA Administrator Mary K. Wakefield, PhD, RN, in a news release issued Friday.  “We all share the vision of a U.S. health care system that engages patients, families, and communities in collaborative, team-based care.  This coordinating center will help us move forward to achieve that goal.”

The Robert Wood Johnson Foundation (RWJF) and three other leading foundations this summer announced their support for the Center and committed up to $8.6 million over five years. RWJF, the Josiah Macy Jr. Foundation, the Gordon and Betty Moore Foundation, and The John A. Hartford Foundation aim to help make the Center the “go to” coordinating and connecting body for efforts to promote interprofessional education and collaborative practice, as well as a place to convene key stakeholders, develop interprofessional education programs, and identify and disseminate best practices and lessons learned.

“Interest in interprofessional education and team-based care has increased in recent years but we need to move faster,” Maryjoan Ladden, PhD, RN, FAAN, senior program officer at RWJF, said in announcing support from the four foundations. “We hope this Center will foster collaborations between educators and practice organizations to advance the field and improve how care is delivered to patients and families.”

Read the news release from the four foundations.
Read the news release from HRSA.

The U.S. Department of Health and Human Services (HHS) this week announced more than $100 million in new grants to expand and strengthen the nation’s health care workforce. The goal of the funding is to educate and strengthen training for health care workers, and provide fellowships and traineeships.

The grants include:

- Nursing ($30.2 million): Partial loan forgiveness for students who serve as full-time nursing faculty for a designated period of time after graduating from a master’s or doctoral program; grants for schools of nursing to provide financial aid and mentoring to students from disadvantaged backgrounds underrepresented in nursing; and funding for nurse anesthetist traineeship programs for licensed registered nurses enrolled in master’s or doctoral nurse anesthesia programs.

- Dental ($3.0 million): Grants to increase oral health care education capacity for programs that train future faculty in general, pediatric, or public health dentistry, or in dental hygiene.

- Public Health ($48.0 million): Funds for 37 Public Health Training Centers to train current and future public health workers in basic health skills and key public health issues; and grants to expand public health training programs and support medical residency-type fellowships at state and local health departments.

- Interdisciplinary and Geriatric Education ($6.6 million): Grants for projects to train and educate workers to provide geriatric care for the elderly; and support for the collaboration and integration of public health curricula in medical and clinical education.

- Centers of Excellence ($18.8 million): A five-year program to support the recruitment and performance of underrepresented minority students entering health careers, and to support research and the development of curricula, training and resources related to minority health issues.

“These grants and the programs they support are vital to achieving a comprehensive and culturally competent health professions workforce capable of meeting future health care challenges,” HHS Secretary Kathleen Sebelius said in a statement announcing the funds.

Learn more about the new federal grants here and here.

Allison Aiello, PhD, MS, is an associate professor of epidemiology at the University of Michigan School of Public Health, and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program. This post is part of a series on the program, running in conjunction with its tenth anniversary.  The RWJF Health & Society Scholars program is designed to build the nation’s capacity for research, leadership and policy change to address the multiple determinants of population health.

You’ve seen it, used it, and probably even bought it. Its manufacturer claims it keeps your hands free of bacteria, and that it works better than regular old soap. For a couple decades now, Americans have been encouraged by soap manufacturers to buy anti-bacterial hand and bath soap, and many of us have taken them up on it, judging from its ubiquity on store shelves. It comes in pump bottles as well as traditional hand and bath bars, all relying on a similar active ingredient, a chemical called triclosan in liquid soaps and triclocarban in bar soaps. In fact, you can find triclosan in a range of hygiene products, including deodorants, toothpastes, mouthwashes, and more.

The marketing message behind all of them is the same: By killing bacteria—or more accurately, by stopping it from reproducing—the stuff makes us cleaner and safer.

Alas, I’ve spent years researching triclosan, and I can tell you that it’s not nearly so simple. Triclosan may have its uses, but as a soap additive, the bulk of the evidence is that it offers no particular advantage over using regular soap, while posing some worrisome threats to health and the environment. Given that, it’s a mystery to me why it’s allowed on the market years after the problems with it first came to light.

On Monday, U.S. Secretary of Health and Human Services Secretary Kathleen Sebelius announced a four-year, $200 million investment to support the training of advanced practice registered nurses (APRNs). The move was lauded by leaders of the Robert Wood Johnson Foundation (RWJF) and the Center to Champion Nursing in America.

The Secretary went to Duke University’s School of Nursing to announce that the Graduate Nurse Education Demonstration program will reimburse costs associated with training APRNS (nurse practitioners, nurse anesthetists, nurse midwives and nurse specialists) at five networks of hospitals, nursing schools, and community-based clinics and health centers.  They are:  the Hospital of the University of Pennsylvania, in Philadelphia; Duke University Hospital, in Durham, N.C.; Scottsdale Healthcare Medical Center, in Ariz.; Rush University Medical Center, in Chicago, Ill.; and Memorial Hermann-Texas Medical Center Hospital, in Houston, Texas.

The goal, officials said, is to help these highly skilled nurses gain the skills necessary to provide primary and preventive care for Medicare beneficiaries, including in underserved communities.

“This announcement marks a historic moment of investment in the crucial and growing role of nurses in our health care system,” RWJF President and CEO Risa Lavizzo-Mourey, MD, MBA, said. “With 8,000 baby boomers turning 65 and qualifying for Medicare daily, patients everywhere can benefit from the expertise of advanced practice nurses and the expanded access to care they potentially can provide. The decision to extend Medicare funding to nurses recognizes the urgent need to expand the workforce to care for the growing population of Medicare recipients.”

“This relatively modest investment will pay big dividends for consumers by preparing more highly skilled nurses to provide care when and where it is needed,” agreed Susan Reinhard, PhD, RN, FAAN, senior vice president of the AARP Public Policy Institute and chief strategist of the Center to Champion Nursing in America, an initiative of AARP, the AARP Foundation, and RWJF.  “These new health professionals will improve access to crucial primary, preventive, and transitional care across a range of settings—from the hospital, to the home, to convenient care clinics,”

Half of the clinical training provided at the five demonstration sites must take place in the community, outside of hospital settings.  The aim is to ensure that APRNs have skills to provide primary, preventive and transitional care, and to help patients manage chronic conditions.  The funding is authorized under the Affordable Care Act.

Read a news release about the announcement from RWJF and the Future of Nursing: Campaign for Action, an initiative of AARP, the AARP Foundation, and RWJF.

This post, which originally appeared on Business Insider, is part of a series in which Robert Wood Johnson Foundation (RWJF) leaders, scholars, grantees and alumni offer perspectives on the U.S. Supreme Court rulings on the Affordable Care Act. Mark A. Hall, JD, is a professor of law and public health at Wake Forest University, and recipient of a 2004 RWJF Investigator Award in Health Policy Research.

We all knew it would be close, but we never saw this coming: The Affordable Care Act survives, but only because Justice Roberts chose to characterize the individual mandate as a tax. The 5-4 outcome isn’t a surprise, but the particular reason is a big big surprise – one that virtually no one predicted (law professors included). How could we be so right, yet so wrong?

First, the unsurprising part: The Court’s five conservative justices agreed that mandating insurance exceeds Congress’ power to regulate commerce, because uninsured people are not engaged in commerce. The four liberal justices squarely disagreed. Furthermore, based on this flaw, four of the five conservatives (all but Roberts) would have declared the entire Act unconstitutional, with no apparent qualms.

Now, the unexpected. Even though Congress invoked only its commerce power in writing the law, and President Obama went out of his way to avoid calling the individual mandate a tax, Justice Roberts, along with the Court’s four liberals, gave Congress the benefit of the doubt, ruling that the mandate can be viewed as a tax. Like a generous math teacher who gives full credit to a student who stumbles on the right answer by accident even though she completely botched the formula, the Court upheld the mandate on grounds entirely different from what Congress thought it was relying.

How surprising is that? Enough that, out of the dozen or more lower court judges to consider this argument, only one (Judge Wynn on the Fourth Circuit, in the Virginia cases) previously agreed. But now we have five Supreme Court Justices rallying around the government’s last ditch legal defense – one that it almost didn’t argue because of the potential political flak of changing positions on whether something is a tax. Thank goodness the government’s lawyers overruled its P.R. folks.

But the issue was closer than even this. If the mandate is a tax, then the government also has to deal with its own jurisdictional statute, on the books for well over a century, declaring that no one can challenge taxes until they’re assessed. If this procedural bar applied, then the entire case would be premature, leaving us all hanging in suspense for another three years. To avoid this, Justice Roberts and colleagues had to conclude that the mandate is a tax for constitutional purposes, but not for jurisdictional purposes. THAT took some fancy footwork, but these are SMART guys and gals, and so if anyone can pull off that tightrope act, they can.

Legal scholars will continue to parse the decision for weeks, months, and perhaps years, to discern all the implications for future enactments and constitutional challenges to come. For now, based on first inspection, it strikes this reader that the Affordable Care Act survived only because Justice Roberts worked hard to find the one thin line of common ground on which both he and those on the other side of the Court’s ideological divide could stand.

The Department of Health & Human Services (HHS) has awarded $9.1 million to medical students participating in the National Health Service Corps’ Students to Service Loan Repayment Program. In exchange for funds to repay their medical school debts, the 77 students in the pilot program commit to provide primary care services in communities with shortages of health professionals and limited access to care.

After their residencies, participants will spend three years full-time, or six years half-time, working in clinical practice in underserved or rural communities. They can receive annual student loan repayment funds of up to $30,000 while in the program.

The pilot program, created by the Affordable Care Act—the health reform law—aims to help alleviate a shortage of primary care professionals. “This new program is an innovative approach to encouraging more medical students to work as primary care doctors," HHS Secretary Kathleen Sebelius said in a statement.

Read more about the shortage of primary care providers and efforts to recruit primary care physicians in underserved areas.

Wizdom Powell, PhD, a Robert Wood Johnson Foundation (RWJF) Health & Society Scholar (2005-2007) has been chosen for the prestigious White House Fellows program. The nonpartisan program is designed to offer hands-on, up-close experience in government, with participants working at senior levels of the Executive Branch of the federal government. According to the White House, “Selected individuals typically spend a year working as a full-time, paid Fellow to senior White House Staff, Cabinet Secretaries and other top-ranking government officials. Fellows also participate in an education program consisting of roundtable discussions with renowned leaders from the private and public sectors, and trips to study U.S. policy in action both domestically and internationally.”

Powell is currently on leave from her post as an assistant professor of health behavior and health education at the University of North Carolina (UNC) at Chapel Hill Gillings School of Global Public Health, and from her position as a UNC Lineberger Comprehensive Cancer Center faculty member. Her research focuses on the impact of neighborhood, health care and socioeconomic resources on racial health disparities, and she has focused particularly on health disparities among African American men. Earlier this year, she presented findings from her recent work at a gathering of current and alumni Health & Society Scholars at the National Institutes of Health.

Powell will spend her fellowship at the U.S. Department of Defense.

She is the second Health & Society Scholar to be named to the program, following in the footsteps of Mehret Mandefro, MD, MSc, from the 2007-2009 cohort, who served in the Department of Veterans Affairs as part of the 2009-2010 class of White House Fellows. In addition, four RWJF Clinical Scholars have served as White House Fellows.

David Van Sickle, Ph.D., is a former epidemic intelligence service officer with the Centers for Disease Control and Prevention, and a 2006 Robert Wood Johnson Foundation Health & Society Scholar at the University of Wisconsin School of Medicine and Public Health.

This past June, I had the honor of being named one of 17 “Champions of Change” by the White House, in recognition of my work marrying emerging technologies to health care.

According to WhiteHouse.gov, “The Obama administration established the Champions of Change award to recognize and encourage ‘everyday heroes’ working to better their communities through hard work and creative solutions.” Many of these folks – such as awardee Todd Park, chief technology officer at the U.S. Department of Health and Human Services (HHS) – now occupy key roles in government where they are sparking new companies and revolutionizing industrial ecosystems in part by using whole new approaches to data.

As readers of the Robert Wood Johnson Foundation Human Capital Web site may recall, my work to develop a GPS-enabled asthma inhaler caught the attention of the Administration early last year, and I was invited to make a presentation at a Community Health Data Forum sponsored by HHS. The forum was an outgrowth of President Obama’s Community Health Data Initiative, which is focused on making HHS health data available so that software developers and others can put it to innovative and constructive use.

The idea behind the inhaler is to capture valuable data about asthma from daily life, by putting GPS technology to work tracking precisely when and where patients use their inhalers. That’s useful information to patients, because it means they can provide their physicians with the kinds of specifics that generally don’t make it into pen-and-paper logs – often because patients forget to keep track and instead fill them out days or weeks later, in the parking lot of their doctors’ offices, for example! But the device also has public health implications, because when we can identify patterns in asthma incidents, we can sometimes identify and then do something about environmental factors that cause them.

Asthmapolis, the company I formed to bring this to market, is gearing up to manufacture the first commercial version of the sensor and is busy hiring. We're up to six employees now and looking to hire two or three more. Our staff will help educate users and public health officials on the use of the product, design marketing materials, write related apps and more. It’s an exciting time in the life of the company, and it’s been an education moving along the path from idea to prototype to device and eventually to a marketable product. This fall we will launch in major health systems in three states.