I am privileged to work with a creative and dedicated staff that enables NASN day to day operations. Your mission and values guide our collective

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2 I am privileged to work with a creative and dedicated staff that enables NASN day to day operations. Your mission and values guide our collective work. I take this time to publicly share appreciation for the entire NASN staff and consultants. 2

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5 Improves quality and lowers health care costs. Emphasizes wellness promotion and invests in prevention to improve health and reduce overall health costs. Promotes coordinated care models including accountable care organizations, patient-centered medical homes, health IT/electronic health records and offers financial incentives to provide quality care in a cost-effective way. Increases access to health care. Expands Medicaid eligibility for all Americans earning at or below 133 percent of the Federal Poverty Level (FPL) ($31,322 for a family of four in 2013). Creates new state-based consumer-friendly, competitive health insurance marketplaces for individuals and small businesses, which will take effect in Provides tax credits to help purchase health insurance in the new marketplaces for individuals and families earning annual incomes between 133 and 300 percent of the FPL. 5

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7 Provides new consumer protections. Prohibits insurers from denying coverage or increasing costs due to pre-existing conditions or gender. Bans rescissions, lifetime and annual benefit limits. Allows young adults to keep coverage on a family health insurance plan until age 26. Requires insurers to deliver more value for premiums. Provides preventive care without cost-sharing. Ensures choice of primary care provider, pediatrician and OBGYN without referral, and emergency care without prior authorization. Guarantees right to independent coverage appeals. 6

8 Invests in America s nurses. Expands nurse education programs, training capacity and retention. Encourages advance practice training. Supports the nursing profession and improves care by building on existing programs and creating new workforce opportunities. Expands investments in primary care programs, in which nurses play a vital role. 7

9 What new opportunities are available to school nurses through the Affordable Care Act? Implementation of the Affordable Care Act presents new opportunities to move to a health care system focused on increased access to primary care, improved care coordination and an emphasis on prevention and wellness efforts school nurses have focused on from the beginning like keeping children healthy, preventing illness and managing chronic conditions. This is what the future of health care looks like, and it makes the work and expertise of school nurses more important than ever before. Capitalizes on the expertise of the nursing profession through a focus on disease prevention and wellness promotion activities. The Community Transformation Grant program supports state and community initiatives to use evidence-based interventions to reduce tobacco use, prevent obesity and reduce health disparities. To support community prevention efforts, the ACA provides funding to advance activities to improve nutrition and increase physical activity to promote healthy lifestyles and reduce obesity-related conditions and costs. These activities will also support First Lady Michelle Obama s Let s Move! initiative and help implement recommendations of the President s Childhood Obesity Task Force. The ACA also provides funding opportunities for clinical prevention efforts, including immunizations, integrated behavioral health screening, suicide 8

10 8 prevention activities and substance use screenings. To measure and assess the impact of the ACA on the health of Americans, new funds are available for data collection and analysis.

11 Provides new opportunities for innovative payment and reimbursement strategies. Under the ACA, states may have the ability to receive reimbursement for school health services and activities related to community-based prevention, health education and counseling programs. As more families and children become eligible for Medicaid coverage, the ACA gives momentum to encourage and allow school health services provided to Medicaid-enrolled students to be reimbursable. The ACA realigns payment incentives by promoting high quality, efficient care and offering options to providers who are interested in better coordinating care for patients and using health care dollars more wisely. This creates an opportunity for physicians to work more closely with other health providers in the community. Creates new ways to help enroll children and families in health care coverage. The ACA includes new funding specifically for groups and individuals willing to lead enrollment and outreach efforts and partner with local entities, such as Community Health Centers. School nurses are in a strategic position as health care professionals to advocate for and facilitate access to health care for students and their families. 9

12 This will be increasingly critical as millions of children and families become newly eligible for health insurance and will need assistance to navigate the enrollment process. 9

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14 Everyone can tell me the link of their health focus and learning. Well documented. Even Secretary of Education acknowledges it. I always talk about the foundation of building blocks for great education, which includes good physical and emotional health. If children can t see the blackboard they can t do well. If children are hungry they can t do well. If children are obese they are not going to do as well as they should. So we have to collectively make sure that children are physically and emotionally healthy so they can think about AP Chemistry and Biology and Physics and the rest of their learning. -National Prevention-clearinghouse of what is working 11

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17 RN Case Manager Antonelli, Stille,and Antonelli (2008) 81% reduction in ER visits 63% reduction in medical office visits 14

18 15 Photo: Base case analysis results: Program costs: $79 million Costs averted $20. 0 million in medical care costs $26.5 million in parents productivity loss $129.1 million in teachers productivity loss Net benefit: $96.6 million Benefit cost ratio: 2.2:1 Sensitivity analysis results Benefit cost ratio:

19 88% of 10,000 trials resulted in net benefit 15

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