Background
Projections show there will be a national shortage of nurses in the next 8 to 10 years if nothing is done to alleviate the pressures that are driving nurses out of the profession and entice young people into choosing nursing as a career. In the last few years, there has been an increase interest by students in the nursing profession however, a ccording to American Academy of Colleges of Nursing's report on 2004-2005 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, US nursing schools turned away 32,797 qualified applicants from baccalaureate and graduate nursing programs in 2004. The main reason is an insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budget constraints. Three quarters (76.1%) of the nursing schools responding to the 2004 survey pointed to faculty shortages as a reason for not accepting all qualified applicants into nursing programs.
Activities/Actions
In 2006, over 300 bills were introduced in 37 states to address nursing education while 35 of those bills were signed into law. AL legislation provides appropriations for graduate nursing scholarships. CA legislation provides appropriations for nursing programs at state universities. A CO bill creates a nursing faculty fellowship program to fund qualified nursing faculty positions while a second bill establishes a nursing teacher loan forgiveness pilot program. DC creates a loan repayment programs for health professionals in exchange for service in Health Professional Shortage Areas and Medically Underserved Areas. FL legislation appropriates money for nursing education programs while KS legislation funds nursing student loan programs. A LA Senate Concurrent Resolution (SCR) requests the Board of Regents and the Nursing Boards to expand nursing programs. ME legislation provides funding to increase the availability of educational opportunities in nursing. Three bills in MD were enacted including grants to increase the number of bedside nurses, grants for nursing programs, a loan forgiveness program and money for a nurse support program. MI passed legislation funding the expansion of nursing education programs, including the provision of scholarships and grants. A MS bill provides a $6,000 salary increase for all full-time nursing faculty at institutions of higher learning while another bill provides the same salary increase for faculty at Community and Junior Colleges. MO legislation allows nursing student loan forgiveness in the event of full time employment as a licensed nurse. NE legislation changes provisions governing the Nursing Faculty Student Loan Cash Fund while a NM bill provides appropriations to support clinical education and retention of nurses. TN amended a provision within the nursing loan-forgiveness and scholarship program for those who agree to teach in state nursing schools. VT legislation provides loan repayment funding for nurses while WI legislation extends the eligibility for loans to persons enrolled in master's degree programs in nursing and extends loan forgiveness requirements to those employed full time as nurse educators. A WY bill appropriates money to the Wyoming Investment in Nursing Loan and Grant while another bill establishes an educational loan repayment program for students seeking to specialize as APRN's in psychiatry.
Other related legislation enacted in 2006 includes: IL passed a law to study the recruitment and training of master's prepared nurses to serve as nursing school faculty as well as creating a nurse educator scholarship and loan repayment program. IA enacted legislation that allocates funds for a nurse recruitment program, while MA passed a bill which creates a fund to be known as the Workforce Competitiveness Trust Fund, used to support the current and future labor forces of the health care industry.
In 2005, over 250 bills were introduced to address nursing education while eighteen states enacted legislation including: AZ enacted a bill to establish a loan repayment program for behavioral health practitioners including RNs and nurse practitioners. A second bill in AZ allocates more money in the higher education budget to increase the size of nursing programs. AR legislation provides additional consideration in college admissions for individuals from medically underserved areas. Four additional nursing education bills were enacted in AR. The first amends the Arkansas Workforce Improvement Grant Program to provide for nursing education. The second bill expands the opportunity for advanced practice nurses and nursing administrators to receive graduate education through student loans and scholarship programs. A third bill provides $125,000 to Arkansas Northeastern College for the Paragould Nursing Center. The final bill defines any Arkansas Nursing School that is eligible to participate in Title IV Federal Student Aid Programs can participate in the Academic Challenge School Program.
CA enacted three education bills. The first bill establishes a State Nursing Assumption Program of Loans for Education (SNAPLE) for nurses who become full-time nursing faculty members. A second bill expands the Song-Brown Family Physician Training Act to increase training opportunities for nurse practitioners. The final bill increases state budget funding for nursing education. CT legislation creates a nursing loan forgiveness program. DE provides money for various nursing education and training programs. HI legislation establishes the Nursing Scholars Graduate Program at the University of Hawaii for students who agree to be nursing faculty after graduation. Another HI bill appropriates funding for nurse training programs. An ID bill provides loan forgiveness opportunities for potential RNs. IL legislation permits the Board of Higher Education to provide program priority grants that address public demand for health services which include nursing schools. ME legislation creates a nursing loan repayment program for advanced nursing degrees for nurses who will commit to becoming nurse educators. MD amended the current loan repayment/scholarship program. MS legislation authorizes funds for public community and junior colleges to be appropriated for nursing student loan programs. NE legislation provides loans for students who agree to teach in nursing programs. NM created a nurse educator fund while a bill in NY amends the Higher Education Services Corporation Nursing Faculty Scholarship Program to include a loan forgiveness program. A second NY bill changes the name of the NY state nursing faculty scholarship program to the Senator Patricia K. McGee Nursing Faculty Scholarship Program and defines award amounts. ND legislation appropriates money for a loan repayment program for nurse practitioners while the OH state operating budget includes nurse education funding and grants for 2006—07. OK expands scholarships to persons seeking a master's degree as a nurse practitioner. A bill enacted in PA provides appropriations for nursing education.
In 2004, over 140 bills were introduced in 26 states to address nursing education and the following 11 states passed legislation. CA enacted two nursing education bills. One appropriates funding for nursing education by accredited programs and the other provides authorization and funding for California State University to establish entry-level master's degree nursing programs. CT legislation requires the Department of Education to provide financial assistance to four community colleges that enter into partnerships with hospitals to secure private funding to increase faculty members. FL legislation re-creates the Nursing Student Loan Forgiveness Trust Fund. Two bills were passed in IL—the first authorizes scholarships for registered nurses pursuing graduate degrees and to students in those areas identified as shortage areas. The second bill increases the amount of money for nursing scholarships in the Nursing Dedicated and Professional Fund. Enacted legislation in IA designated February 12, 2004 as Iowa Nursing Student and Faculty Day for the purpose of encouraging the state's residents to consider pursuing a career in nursing. LA enacted two study bills. The first requires the Board of Regents to study and report in 2005 issues related to admission of students into the clinical portion of nurse training programs. The second bill requires a task force to address the necessary work force initiatives to address the nursing shortage. MD legislation requires nonresident students enrolled in specific programs with a service obligation requirement to furnish a promissory note prior to qualifying for reduced tuition. MO legislation establishes the Missouri Area Health Education Center's program designed to improve the supply, distribution, availability and quality of healthcare personnel. MS enacted legislation appropriates money to support public community and junior colleges including nursing programs. NC legislation allows Cabarrus Memorial Hospital to award advanced degrees to graduates of nursing programs. VT legislation provides funds for health professional loan repayment for those who practice in health professional shortage areas.
States enacted the following legislation in 2003: AR passed two bills, the first reestablished the Nursing Student Loan Revolving Fund and the second established a legislative commission to study the nursing shortage. CA legislation requires the Office of Statewide Planning and Development to establish a statewide Associate Degree Nursing Scholarship Pilot Program. FL legislation will establish the North Brevard Co. Hospital District Board and a training school for nurses. A GA bill will provide financial assistance to students, postgraduate trainees or parents for programs of study in fields with personnel shortages. HI 's bill creates a nurses education loan program of up to $10,000 per student per year along with a special fund. IN legislation extends the date for a report from the Commission on Excellence in Health to October 31, 2004. LA legislation provides that certain students studying to become qualified to teach nursing to be eligible for a loan repayment program. MS also approved two bills, both pertain to the enactment of a paid educational leave program, one for hospital employees working in sponsoring hospitals, the other for employees of state health institutions. Default on these contracts could lead to loss of license. NH legislation combines the states career incentive program and the nursing leveraged scholarship lean program within the Department of Postsecondary Education and establishes a workforce incentive program. NV enacted a bill creating a Committee to Evaluate Higher Education that will study areas of high priority areas including education programs for students who desire to become nurses or teachers. OR enacted a bill that directs the Oregon Health and Science University to distribute grants to post-secondary institutions to expand the capacity of nursing education programs. OR also passed a resolution that urges the Governor to allocate money under the Federal Workforce Investment Act for training of providers to alleviate the shortage of nurses. SD decided to expand their nurse tuition reimbursement program to include recruitment incentive payments of $5,000 to other health care professionals provided they practice full-time in an eligible facility for a minimum of two years. TX legislation requires the TX Higher Education Coordinating Board to adopt procedures for assuring money to fund enrollment growth for nursing programs, grants for faculty, innovations, retention and critical shortage areas. It also creates the Nurse Advisory Committee and adds an RN to the State Council and establishes a nurse resource section within the health profession resource center. VA has enacted a bill that requires the State Council of Higher Education to develop with the Board of Nursing and the Advisory Council on the Future of Nursing, a strategic plan to ensure adequate supply of nurses and must address issues regarding education, recruitment and retention. The Council shall recommend changes in public policy necessary to meet the need for nursing services to the General Assembly. WY agreed to establish a program that encourages nursing education, provides eligibility criteria and loan administration for nursing students, requires the community college commission to coordinate nurse education programs, and specifies the conditions for funding additional teaching positions.
In 2002, significant legislation included the following: AZ legislation established a five year plan to increase the number of nurses who graduate from nursing programs in Arizona. CA decided to standardize all nursing program prerequisites, admission requirements and corequisites on a statewide basis. CO passed two bills, the first directs the state to develop admission policies for nursing programs at state schools to allow for more students and subject to monies in the More Nurses for CO fund. The second bill creates a 3-year direct care provider career path pilot program. Two bills in FL one authorizes the Department of Health to make payments to nursing graduates of up to $4,000 per year for up to four years who practice in designated facilities. Another creates a grant program for school districts to establish an exploratory nursing program in middle schools and a career and technical education program in high schools to promote a seamless transition to post secondary education or employment. IA created a nurse recruitment program with funds to be administered by the College Student Aid Commission. KY legislation creates the Nursing Workforce Foundation to provide funding and award grants to nursing education programs and nursing employers for the recruitment of students and the training of registered nurses who are pursing advanced degrees to become nursing faculty. LA passed two bills, one establishes a commission to address, among other things, the education of future health care workers while the second bill is a study to develop a special high school curriculum in medical sciences. MI agreed to authorize the disbursement of funds to nursing scholarship programs and in a second bill, created a nursing school program that awards $4,000 for each year a student is in the program (funded through the tobacco settlement). Two SD bills revise provisions regarding the nurses' education assistance loan program by funding tuition reimbursement ($5,000) for nurses upon practicing for two years and makes an appropriation to expand the nursing programs at South Dakota's public universities. VA legislation allows part-time nursing students to be eligible for scholarship and loan repayment programs, while WV legislation creates a scholarship program for persons pursing a master's degree in nursing ($10,000) or a fourth year medical student ($20,000) who agrees to practice at least two years in a medically underserved area in West Virginia or a nurse who agrees to teach two years for a school of nursing.