1. CT Colleagues in Caring Testimony Nursing Shortage February 22, 2001

2. Scope of Colleagues Project Began nursing workforce analysis of supply and demand in CT in 1996 (RN & LPN) Began nursing workforce analysis of supply and demand in CT in 1996 (RN & LPN) Does this work through a consortium of representatives from all segments of the healthcare delivery system, nursing education system, professional nursing organizations, payers, labor, regulatory bodies Does this work through a consortium of representatives from all segments of the healthcare delivery system, nursing education system, professional nursing organizations, payers, labor, regulatory bodies

3. Reports Nursing Workforce Report Forecasting for the 21 st Century December 1998 Nursing Workforce Report Forecasting for the 21 st Century December 1998 Nursing Workforce Status Report 2000 Nursing Workforce Status Report 2000 December 2000

4. U.S. Department of Labor Criteria for Determining a Nursing Shortage The occupation must be in disequilibrium where the number of workers employers wish to hire exceeds the number willing to work at prevailing wages. The occupation must be in disequilibrium where the number of workers employers wish to hire exceeds the number willing to work at prevailing wages. The market adjusts slowly, if at all, with the achievement of equilibrium requiring a substantial period of time. The market adjusts slowly, if at all, with the achievement of equilibrium requiring a substantial period of time.

5. RN Nursing Shortage 1999-2001 1999 RN vacancy rates in acute care hospitals doubled from 3.7 in 1997 to 8%.* 1999 RN vacancy rates in acute care hospitals doubled from 3.7 in 1997 to 8%.* 1999 RN vacancy rate in specialty units rose to 10%. 1999 RN vacancy rate in specialty units rose to 10%. 1999 RN homecare vacancy rates rose to 9%. 1999 RN homecare vacancy rates rose to 9%. 2001 RN vacancy rate in acute care hospitals has risen to 12%. 2001 RN vacancy rate in acute care hospitals has risen to 12%.

6. Industry Response Increase in RN wages. Increase in RN wages. Increase in monetary incentives to work extra shifts. Increase in monetary incentives to work extra shifts. Hiring bonuses. Hiring bonuses. Retention bonuses. Retention bonuses. More use of mandatory overtime. More use of mandatory overtime. More use of temporary and traveling RNs. More use of temporary and traveling RNs.

7. The Numbers CT Registered Nurses 1996 41,296 CT Registered Nurses 1996 41,296 CT Registered Nurses 2000 41,767 CT Registered Nurses 2000 41,767 Net gain 471 Net gain 471 Net gain for US 1996-2000-133,666 Net gain for US 1996-2000-133,666 Source: National Survey Registered Nurse Population 2000 Source: National Survey Registered Nurse Population 2000

8. New Data Registered Nurse Population CT has 1,617 less RNs employed in 2000 than in 1996. CT has 1,617 less RNs employed in 2000 than in 1996. CT has more RNs employed part-time in 2000 than in 1996. Leaving a shortfall of 2011 FTEs. CT has more RNs employed part-time in 2000 than in 1996. Leaving a shortfall of 2011 FTEs. Source: 1996 and 2000 National Survey Registered Nurse Population Source: 1996 and 2000 National Survey Registered Nurse Population

9. Reasons for Decreased Employment of RNs Wages- Wages- good to start-but not for longevity. Working Working conditions-increased dissatisfaction in ability to deliver care. Retirements-CT Retirements-CT RNs are older than US RNs. Family Family Responsibilities-53.2% of RNs have children at home. Economic Economic Status-72% of nurses are married and are second wage earners. 95% 95% are female, work less over their careers.

10. Nursing School Enrollments Enrollments have decreased in RN programs over the past 20 years from a high of 1400 to a low of 780 now. Enrollments have decreased in RN programs over the past 20 years from a high of 1400 to a low of 780 now. A poorly qualified applicant pool has led to 50% attrition rates in LPN programs and 30% in RN programs. A poorly qualified applicant pool has led to 50% attrition rates in LPN programs and 30% in RN programs. Current capacity in RN programs is 950 per year or class. Current capacity in RN programs is 950 per year or class. Capacity in LPN programs is 575. Capacity in LPN programs is 575.

11. RNs and LPNs Needed per Year to Avert a Severe Shortage In order to replace the 50% of employed RNs expected to retire in the next 15 years, we need to graduate 1200 RNs per year for the next 15 years. In order to replace the 50% of employed RNs expected to retire in the next 15 years, we need to graduate 1200 RNs per year for the next 15 years. We graduated 584 in 1998-1999, the last year for which statistics are available. We graduated 584 in 1998-1999, the last year for which statistics are available. Current graduation rates of 350 LPNs is sufficient to replace retiring RNs as long as employers not 11using RNs continue not to do so. Current graduation rates of 350 LPNs is sufficient to replace retiring RNs as long as employers not 11using RNs continue not to do so.

12. Ending the Shortage Decrease Demand-Reduce access to care. Decrease Demand-Reduce access to care. Increase Supply. Increase Supply. Do a combination of both. Do a combination of both. It’s time to increase the supply. It’s time to increase the supply. Colleagues in Caring supports the initiatives set forth in AN ACT CONCERNING THE NURSING AND HEALTHCARE WORKFORCE SHORTAGE. Colleagues in Caring supports the initiatives set forth in AN ACT CONCERNING THE NURSING AND HEALTHCARE WORKFORCE SHORTAGE.

13. CT Initiatives Nursing Career Center of CT. Inc. Nursing Career Center of CT. Inc. RB 1374 AN ACT CONCERNING NURSING AND HEALTH CARE WORKFORCE SHORTAGE RB 1374 AN ACT CONCERNING NURSING AND HEALTH CARE WORKFORCE SHORTAGE –Establishes Nursing Commission –Increases funding to Nursing Programs –Has scholarship provisions –Increased Medicaid reimbursement –Establishes a technology access task force