DURHAM — Duke University Hospital is one of five hospitals in the nation that will share in $200 million over four years to prepare more nursing students who want advanced training, an effort to fill gaps in clinics, doctors’ offices and hospitals that don’t have enough primary-care health professionals.

Kathleen Sebelius, U.S. Health and Human Services secretary, came to Duke’s nursing school Monday to announce the program, which is funded through the federal health care law.

The money will go to educate advanced practice registered nurses: nurse practitioners, clinical nurse specialists, nurse anesthetists and nurse midwives.

The initiative is intended to make it easier for patients to find primary care, a goal of the federal law.

The other hospitals selected are in Philadelphia, Chicago, Houston and Scottsdale, Ariz.

“With today’s investments, we’ll put more nurses in communities across the country, shortening waiting lists for appointments in community health centers, decreasing delays in discharging patients from hospitals, and providing more time for patients and their health care providers to interact,” Sebelius said.

The pool of people with health insurance is expected to greatly expand in a few years. Starting in 2014, individuals and small businesses will be able to shop for plans on an insurance exchange.

States will have the option of expanding Medicaid – the state and federal insurance plan – to people who are not now eligible. In North Carolina the expansion would initially add about 525,000 people to the program.

That influx will come as the nation is dealing with a shortage of primary-care doctors. Training more advanced practice nurses is one of the strategies for increasing the pool of professionals who can provide primary care.

“We are proud to be a part of this important effort to help solve this problem,” said Dr. Victor J. Dzau, president and CEO of Duke University Health System.

Advanced nursing benefits

Duke officials said the money will allow them to expand by 216 students over four years. Duke estimates it will cost $49,000 a year to train each nurse practitioner.

One of the requirements for Duke and the other hospitals is to have half the clinical training for students occur in non-hospital settings. Students will work with specially trained instructors in clinics, doctors’ offices and community hospitals through a 14-county region that includes the Triangle.

“This will allow new nurses to practice in the heart of communities,” Sebelius said.

Sharon Elliott-Bynum, co-founder of a Durham clinic that provides free care to patients who don’t have health insurance, called news of the program “a great moment in the city of Durham.”

Healing with CAARE Inc., will be one of the places where nurse practitioners are trained.

The U.S. Supreme Court upheld most of the health care law’s provisions, but Congressional Republicans continue efforts to repeal it.

The Obama administration has increased funding for nurses with special training, expanded the reach of community health care centers, and provided incentives for doctors to deliver primary care and for health care professionals to work in under-served areas, Sebelius said.

Bonner: 919-829-4821