October 2, 2007
By: John Kasprak, Senior Attorney
You asked for information on steps Connecticut is taking to address the nursing shortage. (This report updates an earlier OLR Report, 2002-R-0681.)
Recent state initiatives addressing the nursing shortage include the establishment or expansion of programs designed to increase the number of nursing faculty in the state; loan repayment programs to provide incentives for nurses and other health care professionals to work in medically underserved areas; funding to various higher education institutions to increase their number of nursing graduates; establishing a loan forgiveness program for historically underrepresented students pursuing nursing careers; recruitment and retention campaigns; and other allied health workforce initiatives.
In 2004, the General Assembly passed legislation (PA 04-196) establishing a Connecticut nursing faculty incentive program administered by the Office of Workforce Competitiveness (OWC). The program must provide grants, within available appropriations, to higher education institutions that work with hospitals to:
1. establish or expand nursing education programs that qualify people to teach or train nursing students enrolled in a bachelor's or registered nurse (RN) certification program or
2. encourage those who already have those qualifications to serve as full-or part- time faculty members at these institutions.
OWC had to submit a status report on the program to the Education, Public Health, and Higher Education and Employment Advancement committees by January 1, 2006. This act also required the Higher Education Department (DHE) commissioner to report to the Public Health and Higher Education and Employment Advancement committees, by January 5, 2005, on the department's assessment of the capacity of the state higher education system to educate and train nurses. (The report is attached.)
PA 04-253 established a Connecticut nursing incentive program, administered by DHE. It appropriated $200,000 to DHE for the program in FY 2004-05 of which the department could use up to 2% for program administration in FYs 05 and 06. The program required DHE to provide financial assistance to up to four regional community-technical colleges that entered into partnerships with hospitals or other health care institutions to secure non-state funding to increase their faculty numbers. Under the act, DHE could provide assistance to a college for up to two years, but it could not provide more than $75,000 per year or the amount of private funding secured by the partnership, whichever was less. Capital, Norwalk, Naugatuck, and Three Rivers community colleges received funding for this purpose in FY 05.
PA 04-221 extended licensure by endorsement to (1) RNs and licensed practical nurses (LPNs) licensed in the District of Columbia and Puerto Rico (and other U.S. commonwealths). They can obtain a license in this way as long as they are not the subject of a professional disciplinary action or unresolved complaint and those jurisdictions' licensing standards are at least equal to Connecticut's. (RNs and LPNs licensed in other states and U.S. territories could already obtain a license by endorsement.) The act specified that RNs or LPNs must be licensed in the other jurisdiction when they apply for a Connecticut license.
PA 04-221 allows the Department of Public Health (DPH) to issue 120-day temporary permits to (1) licensure by endorsement applicants from the District of Columbia and Puerto Rico (and other U.S. commonwealths) and (2) nurses whose Connecticut licenses were voided for failure to renew on time. This act also allows graduates from DPH-approved nursing programs to work as RNs and LPNs for up to 90 days after graduation.
PA 06-195 permits a graduate advanced practice registered nurse (APRN) to work without a license, for 120 days after graduating, in a hospital or other setting under the supervision of a physician or other APRN.
State law authorizes DPH to establish, within available appropriations, a program providing three-year grants to community-based, primary care service providers to expand access to health care for the uninsured. PA 06-195 specified that these providers can also provide nursing services in a school-based health center. The grants may be awarded to recruit and retain primary care clinicians and RNs through salary subsidies or a loan repayment program. By law, participating clinicians and nurses must provide services to the uninsured based on a sliding fee schedule, provide free care if necessary, accept Medicare assignment, and participate as a Medicaid provider.
PA 07-219 requires the Department of Social Services (DSS), within available appropriations and in consultation with DPH, to establish a pilot training program for nurse practitioners seeking to specialize in family practice. Under the program, the nurse practitioner receives one year of formal training at a community-based health center in a federally designated health professional shortage area, medically underserved area, or area with medically underserved populations. The DSS commissioner, in consultation with the DPH commissioner, must establish program eligibility requirements. The pilot programs must begin by October 1, 2008 and end by October 1, 2010.
CURRENT BUDGET INITIATIVES
The following information was provided by the Office of Fiscal Analysis.
Department of Public Health (DPH)
DPH receives $375,000 in each of FYs 08 and 09 to support initiatives to address nursing and allied health workforce shortages. These initiatives can include a faculty scholarship program, a nursing faculty student loan program, grants to higher education institutions for faculty positions, a recruitment and retention campaign to promote awareness of nursing and allied health careers, and support for an allied health workforce policy board. (The nursing faculty student loan program would provide loans and loan forgiveness to state residents who pursue a master's or doctoral degree from an accredited nursing program in the state and agree to engage in nursing instruction in an approved state nursing training program.)
Also, the budget provides funding of $125,000 in each of FY 08 and 09 to DPH to establish a loan forgiveness program for historically underrepresented students pursuing nursing careers.
University of Connecticut
UConn receives funding totaling $200,000 in both FY 08 and 09 for the Masters Entry into Nursing Program (MbEIN). This program is designed for those with a bachelor's degree in a non-nursing field. Upon successful completion of the program, the student is awarded a certificate in basic nursing and can take the RN licensure exam.
Connecticut State University (CSU)
Funds totaling $295,000 are provided to increase the number of state nursing graduates. This funding includes three faculty positions ($195,000), one at Western and two at Southern. Additionally, $100,000 is provided in support of BSN Accelerated Career Entry scholarship stipends at Southern.
Funding totaling $140,000 in each year of the biennium is provided to match funds from private hospitals in support of nursing faculty and other expenses at Norwalk Community College ($90,000) and three Rivers Community College ($50,000).
Department of Education
The FY 08-09 state budget increases technical high school nursing staff by providing $400,000 for four positions (nursing supervisor and three additional faculty).
Department of Higher Education (DHE)
Health Education awards for FYs 08 and 08 are to be spent on health and education initiatives, at the discretion of the DHE commissioner. Funds do not have to be spent on nursing shortage issues. (See the attachment for details on the distribution of FY 07 funds.)