Denisse Castillo 7904 Greenebrook Court Fairfax Station, VA 22039 dac56478@marymount.

edu (703) 220-7882

September 23, 2011 The Honorable Gerald E. Connolly Congressional Representative for District 11 of Virginia United States House of Representatives 424 Cannon House Office Building Washington, DC 20515 Dear Representative Gerald E. Connolly, I am writing to gain your support for the passage of S. 55 the Nursing School Clinic Act of 2011. Passage of this bill would increase accessibility to healthcare, decrease health care costs, decrease emergency room visits, and decrease hospital admissions particularly among poor underserved communities. The Nursing School Clinic Act is sponsored by Senator Daniel Inouye representative of Hawaii. Its purpose is, to amend title XIX of the Social Security Act to provide for coverage of services provided by nursing school clinics under the state Medicaid programs (Govtrack.us). This act would help fund nursing school based clinics, and expand availability of healthcare services. The primary benefits to the passage of this bill are: increased accessibility and decreased cost of health care. According to an article by Rose (2011) clinics managed by nurses have cut back on emergency room visits and hospital admissions resulting in decreased health care costs and cost associated with absence from work (Rose, 2011). Saving money is important in the current economy for both the consumer and the government. The economic recession of 2009 increased the number of enrolled in Medicaid as more people lost their jobs and health benefits. The recession also increased the demand for public health nurse-managed clinics (Chesney, Smitherman, Taueg, Mach & Smith, 2010). Allowing nursing school based clinics to bill Medicaid would help bridge the gap to the under-serviced, since low reimbursement rates in many states have limited the number of Medicare participating providers (Eberly, Davioff & Miller, 2010). According to the National Nursing Centers Consortium (2010), nurse practitioners provide high quality, cost effective care. In a study by the NNCC it was determined: -nurse practitioners provide care of equivalent quality to physicians at a lower cost, while achieving higher levels of patient satisfaction and providing more disease prevention counseling, health education, and health promotion activities than physicians. -national average cost of a NP visit was 20% less than a visit to a physician. -a worksite run by a single nurse practitioner resulted in direct medical costsavings of nearly $2.18 million over a two year period, without including indirect savings related to lost productivity and absences.

Denisse Castillo 7904 Greenebrook Court Fairfax Station, VA 22039 dac56478@marymount.edu (703) 220-7882
-No matter the setting, nurse practitioner care has proven to be a highquality, cost-effective means of primary care delivery (NNCC, 2010). Nursing school based clinics are primarily managed by nurse practitioners and they work collaboratively with physicians, dentists, other health care providers, community agencies, staff nurses, and volunteers. The primary focus of the clinics is: disease prevention and wellness. I am currently a nursing student. Having done clinical rotations in acute care and community settings I have seen first hand the positive impact on health that such programs have on individuals and families. Passage of the Nursing School Clinic Act of 2011 would allow Medicaid to be billed, increasing program funding, allowing increased accessibility to health care and decreasing costs to individual clients. Government spending on health care benefits and programs would decrease as well; this would be beneficial since health care spending in this country accounts for more than 16% of the GDP. Of that 16%, more than 77.1% of that was used to fund Medicaid and Medicare programs in 2007 (Jernson, 2008). These percentages have been on the rise since 2009 and the economic recession. Please assist in the passage of the S. 55 Nursing School Clinic Act. Its passage would be mutually beneficial to both government and consumers. Thank you for your time and attention to this matter. Please contact me at the any time via e-mail or phone if I can be of any assistance. Sincerely,

Denisse Castillo ATC & Student Nurse

Denisse Castillo 7904 Greenebrook Court Fairfax Station, VA 22039 dac56478@marymount.edu (703) 220-7882
Jenson, J. (2008), Congressional research service reports for congress, Government spending on healthcare benefits and programs: A data brief [RS22898]. Retrieved from http://aging.senate.gov/crs/medicaid7.pdf Rose, J.F. (2011), Nursing for the people, In health reform climate, nurse-managed health centers model care for underserved communities, Nurse-run clinics offer hope for nations tired, poor and uninsured. Advance for Nurses. Retrieved from http://nursing.advanceweb.com/Editorial/Content/PrintFriendly.aspx Eberly, T., Davidoff, A. & Miller, C. (2010). Managing the gap: Evaluating the impact of Medicaid managed care on preventive care receipt by child and adolescent minority populations. Journal of Health Care for the Poor and Unerserved, 21(1). doi: 10.1353/hpu.0.0246 Chesney, J.D., Smitherman Jr., H.C., Taueg, C., Mach, J. & Smith, L., (2010). Taking care of the underserved: A path to reform. Journal of Health Care for the Poor and Underserved. 21(1). doi: 0.1353/hpu.0.0268 National Nursing Centers Consortium, (2010). The cost effectiveness of nurse practitioner care. Retrieved from http://www.nncc.us/site/pdf/CostEffectiveness_of_NP_Care.pdf Govtrack.us. (2011) S. 55 Nursing School Clinic Act of 2011. Retrieved from http://www.govtrack.us/congress/bill.xpd?bill=s112-55