1. United States Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions NATIONAL COUNCIL OF STATE BOARDS OF NURSING (NCSBN) Faculty Shortage: Implications for Regulation Federal Funding Solutions Joan Weiss, PhD, RN, CRNP Acting Director Division of Nursing March 26, 2008

2. ANALYZING THE SUPPLY OF THE FUTURE NURSE EDUCATOR WORKFORCE FROM THE NATIONAL SAMPLE SURVEY OF REGISTERED NURSES

3. DEFINITION OF NURSE FACULTY Nurse Faculty: Nurse Faculty are nurses who hold a primary position as a Dean, professor, or instructor who educationally prepares registered nursing students at the associates, baccalaureate, masters and doctoral degree levels. -NSSRN, 2004

4. NSSRN 2004 FINDING:NURSING FACULTY EMPLOYMENT Over 56,500 RNS are employed as faculty in nursing programs

5. NSSRN 2004: FACULTY IN BS OR HIGHER PROGRAMS

6. NSSRN 2004: FACULTY RNS IN BS OR HIGHER PROGRAMS BY RACE/ETHNIC BACKGROUND

7. NSSRN 2004: FACULTY RNs IN BS OR HIGHER PROGRAMS BY HIGHEST EDUCATIONAL PREPARATION

8. NSSRN 2004: PERCENTAGE OF FULL-TIME AND PART-TIME FACULTY * N= 11,888 for Full-time Instructors * *

9. NSSRN 2004: FACULTY RNs IN BS OR HIGHER PROGRAMS BY AGE OF NURSES Average Age of RNs is 50.4 years

10. NSSRN 2004: FACULTY RNs IN BS OR HIGHER PROGRAMS BY TIME IN ACTIVITIES

11. NSSRN 2004: FACULTY RNs IN BS OR HIGHER PROGRAMS BY UNIT WITH MOST PATIENT CARE

12. NSSRN 2004: FACULTY RNs IN BS OR HIGHER PROGRAMS BY PERCENT OF TIME IN TEACHING

13. NSSRN 2004: FACULTY RNs IN BS OR HIGHER PROGRAMS BY PERCENT OF TIME IN RESEARCH

14. NSSRN 2004: FACULTY RNs IN BS OR HIGHER PROGRAMS BY SATISFACTION WITH PRINCIPAL NURSING POSITION

15. NSSRN 2004: FACULTY RNs IN BS OR HIGHER PROGRAMS BY PORTION OF YEAR IN PRINCIPAL POSITION

16. NSSRN 2004: THE AVERAGE EARNINGS OF NURSING FACULTY BY PROGRAM

17. HRSA PREPARES QUALIFIED NURSING FACULTY IN THREE AREAS: 1.Advanced Education Nursing Program (AEN) (Supports for Masters and Doctoral education) –Advanced Education Nursing Program (AEN) –Advanced Education Nurse Traineeship Program (AENT) –Nurse Anesthetist Traineeship Program (NAT) 2. Nurse Education Practice and Retention Program (NEPR) –Faculty Development Initiative –Integrated Technology into Nursing Education and Practice (ITNEP) 3. Nurse Faculty Loan Program (NFLP)

18. ADVANCED EDUCATION NURSING PROGRAM (AEN)

19. LEGLISATION: TITLE VIII- SECTION 811 Sec. 811 –A major component of Title VIII legislation is to provide: program grants for the enhancement of advanced education and practice, and traineeship grants to institutions for student support in advanced education Section 811: Levels of Programs Masters and Doctoral programs Combined RN/Masters programs Post-nursing Masters certificate programs Certificate nurse-midwifery programs in existence on November 12, 1998

20. DIVISION OF NURSING (DN) BUDGET FY 2006- 2008 * in millions

21. ELIGIBLE APPLICANTS FOR AEN & NFLP PROGRAMS Eligible Applicants must be accredited: Collegiate schools of nursing; Academic health centers; and Other public or private entities accredited by a national nurse education accrediting agency or State approval agency recognized by the Secretary of the U.S. Department of Education. Length of Support: Competing Applications Three (3) years No planning year allowed: Projects should be ready to enroll students in the first semester/quarter after funding.

22. GUIDELINES FOR AEN PROGRAMS Projects that have a nursing educator component must: –lead to a masters degree, post-masters certificate or doctoral degree –provide evidence of adherence to national nursing organizational guidelines and competencies Programs must prepare nurse educators to: –function in a complex educational environment –to teach traditional as well as non-traditional learners using a variety of emerging technologies and interdisciplinary skills. Graduates must be eligible for national nursing organization certification in advanced practice or advanced level specialty.

23. AEN GRANTS WITH A NURSE EDUCATOR FOCUS 2006-2007 Educator Programs by Degree Level Doctoral: A program of instruction beyond the baccalaureate and masters degrees in nursing (e.g. PhD, DNS, DSN, DNSc, DNP). Doctoral programs in nursing fall into two principal types: research focus and practice focus. MSN: An advanced program of instruction beyond the associate and baccalaureate degrees in nursing (e.g. MSN, MS). Master-level programs have a range of nursing specialties (nurse educator, nurse- midwifery, forensic, nurse practitioner, anesthesia, etc.) Post-MSN Certificate: A formal, post-graduate program for registered nurses with master's degrees that awards a certificate and academic credit that is documented on a graduate transcript from the school for completion of the program of study as a Nurse Practitioner, Nurse- Midwife, Clinical Nurse Specialist, or other advanced level nursing program of study.

24. AEN GRANTS WITH A NURSE EDUCATOR FOCUS BY DEGREE LEVEL 2006-2007 * 2007 includes 2-MSN and 2-Doctoral no-cost extension grants. In the PhD only category, one program offers the BSN/ PhD Option. * * *

25. AEN: GRANTS WITH NURSE EDUCATOR FUNDING SUPPORT 2006-2007

26. DOCTORAL PROGRAMS THAT PREPARE QUALIFIED NURSE FACULTY Arizona State University, College of Nursing (# 05320) –DNS for roles as faculty, clinical nurse leaders, and evidence- based clinical researchers University of South Alabama (# 07984) –DNP for roles as a nurse educator University of Nevada, Las Vegas Board of Regents, NSHE (# 07966) - PhD for roles as a nurse educator Marquette University (# 00571) –PhD for roles as teacher-scholars

27. DOCTORAL PROGRAMS THAT PREPARE QUALIFIED NURSE FACULTY (CONT.) University of Colorado, CO Springs (# 07976 ) –DNP roles in faculty development University of Washington (# 07344) –DNP for roles as an educator with a focus on health care University of Cincinnati (# 05327) –BSN-PhD for roles as faculty and clinical nurse leaders addressing rural health, health disparities, and health promotion University of Texas, Arlington (# 07342) –BSN-PhD for roles as faculty and clinical nurse leaders addressing rural health, health disparities, and health promotion

28. DOCTORAL PROGRAMS THAT PREPARE QUALIFIED NURSE FACULTY (CONT.) No- Cost Extension Grants: Hampton University (# 00247) - PhD roles as a nurse educator University of Arizona (# 03116) - DNSc program in faculty development as a nurse leader

29. ADVANCED EDUCATION NURSE TRAINEESHIP PROGRAM (AENT)

30. PURPOSE Authorizes grants to meet the costs of traineeships that will pay all or part of the costs of the tuition, books, reasonable living expenses and fees of graduate students enrolled in advanced education nursing programs.

31. USE OF GRANT FUNDS Stipends (maximum of $8,800 per student) Full tuition and fees Trainee travel is not allowable Required textbooks up to $500 per trainee. Books for library or personal/professional use may not be charged to the grant. Only full-time, first-year nurse anesthesia students may be supported under the AENT program. Institutions should submit a separate Nurse Anesthetist Traineeship Program grant application to support nurse anesthesia students enrolled beyond the first 12 months of study.

32. ELIGIBLE STUDENTS Eligible Student must be: Enrolled full-time or part-time (within the last 12 months of study prior to graduation) In an advanced education nursing program for preparation as a: nurse practitioner, nurse-midwife, nurse anesthetist, clinical nurse specialist, public health nurse, nurse administrator, nurse educator, * or other nurse specialty determined by the Secretary to require advanced education

33. Students must also be: Pursuing a Masters or doctoral degree, a combined RN to Masters degree, a nurse-midwifery certificate, or a post-nursing Masters certificate Citizen of the United States, a non-citizen national, or foreign national who possesses a visa permitting permanent residence in the United States Eligible for national nursing certification in the nursing specialty or field of study (as applicable) following graduation ELIGIBLE STUDENTS

34. NURSE ANESTHESIA TRAINEESHIP PROGRAM (NAT)

35. PURPOSE Authorizes grants to meet the costs of traineeships for licensed registered nurses enrolled as full-time students beyond the twelfth month of study in a masters or doctoral nurse anesthesia program. Traineeships will pay all or part of the costs of the tuition, books, fees and reasonable living expenses of the individual during the period for which traineeship is provided.

36. ELIGIBLE STUDENTS Eligible Students must be: A registered nurse enrolled at the institution in a qualified advanced education nursing program Citizen of the United States, a non-citizen national, or foreign national who possesses a visa permitting permanent residence in the United States Enrolled full-time beyond the 12 months of study Eligible to sit for the certification examination from the American Association of Nurse Anesthetists Council on Certification of Nurse Anesthetists to become a Certified Registered Nurse Anesthetist (CRNA)

37. STATUTORY FUNDING PREFERENCE (AENT & NAT) Preference will be given to qualified applicants that demonstrate a: High rate of graduates accepting positions in medically underserved areas; and a Minimum of 40% of graduates who spend at least 50% of work time in these areas. Special consideration will be given to eligible applicants who: will use the award to train advanced education nurses who will practice in Health Profession Shortage Areas (HPSAs) provide applicant assurance meet a minimum 10% of students who sign commitments to practice in HPSAs after graduation

38. NURSE FACULTY LOAN PROGRAM (NFLP)

39. NURSE FACULTY LOAN PROGRAM PURPOSE The Nurse Faculty Loan Program (NFLP) is authorized under- Title VIII, Section 846A of the Public Health Service Act, as amended by the Nurse Reinvestment Act of 2002 to increase the number of qualified nursing faculty.

40. NURSE FACULTY LOAN PROGRAM STRATEGIC GOALS Promote recruitment of nursing students to become nurse faculty, Provide financial support for students enrolled in an advanced education nursing program to prepare qualified nurse faculty, and Retain loan recipients as nurse faculty by providing loan cancellation over a consecutive four-year period.

41. Collegiate schools of nursing or another entity within the college/university that offers advanced degree nursing program can apply for NFLP funds. Schools must offer an advanced education nursing degree program(s) that is fully accredited and prepares qualified nurse faculty. Schools must be located in the U.S., District of Columbia, or U.S. territories. NURSE FACULTY LOAN PROGRAM ELIGIBILITY

42. HHS enters into an agreement with a school of nursing and makes an award, the Federal Capital Contribution (FCC), to establish and operate a distinct account for the NFLP fund. The school must contribute an Institutional Capital Contribution (ICC) amount equal to at least 1/9 of the FCC award. The ICC must be deposited and used as part of the NFLP fund. NURSE FACULTY LOAN PROGRAM ESTABLISHMENT

43. The NFLP fund may only be used for the deposit of the FCC and ICC; – to make loans to students enrolled full-time in a masters or doctoral nursing degree program with an education component that will prepare them to teach; for the deposit of collections of principal & interest on loans made from the NFLP fund; and for the cost of collection of NFLP loans. NURSE FACULTY LOAN PROGRAM ESTABLISHMENT (CONT.)

44. Student Eligibility U.S. Citizenship or Permanent Resident Full-time Enrollment in the eligible nursing program (Adding part-time enrollment in FY 2008) Good Academic Standing Not in Default on Other Federal Loans NURSE FACULTY LOAN PROGRAM BENEFICIARY ELIGIBILITY

45. Other Requirements NFLP loan recipients must enroll for a minimum of two consecutive terms/semesters during the academic year. NFLP loan recipients must complete the specified education component to prepare qualified nurse faculty prior to graduating from the nursing program.

46. NURSE FACULTY LOAN PROGRAM PROVISIONS Students may borrow a maximum of $30,000/ year for no more than 5 years of support. NFLP loans may be used to cover full/ partial tuition, the costs of fees, books and other reasonable education expenses. Personal living expenses or stipends are not supported. NOTE: NFLP is not a need-based program.

47. NURSE FACULTY LOAN PROGRAM PROVISIONS Following completion of the program, NFLP loan recipients may cancel up to 85% of the NFLP loan over a consecutive four-year period when they serve as full-time faculty at a school of nursing. NFLP loan recipients receive cancellation of the loan principal and interest – 20% cancellation upon completion of each 1 st, 2 nd and 3 rd year of employment as full-time faculty; and 25% cancellation upon completion of the 4 th year of employment as full-time faculty.

48. NFLP loans bear interest on the unpaid balance at a rate of 3% per year – beginning three months after completion of the program NFLP loans bear interest on the unpaid balance at the prevailing market rate over the period of the loan – beginning three months after the borrower drops from the program NURSE FACULTY LOAN PROGRAM INTEREST RATE

49. NFLP loans bear interest on the unpaid balance at the prevailing market rate over the period of the loan – if, following graduation from the program, the borrower does not establish employment following the 9 month grace period; or when the borrower ceases to be employed as full-time faculty at a school of nursing within the 4-year NFLP loan cancellation period allowed.

50. NURSE FACULTY LOAN PROGRAM ADMINISTRATION The School of Nursing is the eligible applicant; therefore the school of nursing must submit the NFLP application. The Financial Aid Office generally administers the NFLP fund and conducts activities, i.e. – Issuing the Promissory Note Loan Disbursement Employment Verification Loan Cancellation Establishing Repayment Schedules

51. NURSE FACULTY LOAN PROGRAM ADMINISTRATION The NFLP Annual Operating Report (AOR) is used to monitor and evaluate institutional performance. Schools must complete and submit the AOR annually. The AOR is used to report expenditures for the NFLP fund annually and covers the period from July 1 through June 30 the following year.

52. NURSE FACULTY LOAN PROGRAM AWARD APPROPRIATIONS 2003-2007

53. NURSE FACULTY LOAN PROGRAM PARTICIPANTS 2003-2007

54. NURSE FACULTY LOAN PROGRAM ENROLLEES 2003-2007 * The number of enrollees for years 2003 and 2004 are not available (n/a). **

55. NURSE FACULTY LOAN PROGRAM ENROLLEES FY 2007

56. NURSE FACULTY LOAN PROGRAM GRADUATES FY-2007

57. FACULTY DEVELOPMENT: INTEGRATED TECHNOLOGY INTO NURSING EDUCATION AND PRACTICE INITIATIVE (ITNEP)

58. TITLE VIII: SECTION 831 LEGISLATION Three Priority Areas: 1. Education Purposes 1: To expand enrollment in baccalaureate nursing programs 2: To develop and implement internships and residency programs 3: To provide education in new technologies including distance learning 2. Practice Purposes 1: Establish or expand nursing practice arrangements in non-institutional settings 2: Provide care for underserved populations and other high risk groups 3: Provide managed care, quality improvement, and other skills needed to practice in existing and emerging organized health care systems 4: Develop cultural competencies among registered nurses 3. Retention Purposes 1: Career ladder bridge programs which promote career advancement for registered nurses and nursing personnel 2: Enhancing patient care delivery systems

59. PURPOSE Support nursing collaboratives for faculty development in the use of information and other technologies Nursing collaboratives will use healthcare information systems to: –Establish linkages with community colleges, Historically Black Colleges and Universities (HBCUs), Tribal Colleges and Universities (TCUs), Hispanic Serving Institutions (HSIs); –Enhance nursing education and practice; –Optimize patient safety; and –Drive improvements in health care quality.

60. PURPOSE (CONT.) Nursing collaboratives – –Train nurse faculty to effectively teach students to utilize integrated technologies. –Offer state-of-the-art training sites. –Promote the awareness of the latest simulated learning, informatics, and telehealth trends, advances, and issues. –Develop an innovative faculty development plan in the use of simulated learning, informatics, and telehealth.

61. ELIGIBILITY Collegiate schools of nursing capable of carrying out program goals and objectives Eligible applicants must have a formal partnership with one or more: Academic health centers Schools of nursing Accredited public or private institutions Public or private entity

62. TYPE OF AWARD Cooperative Agreement – is a form of a Federal grant; has substantial involvement from the Federal government; and dominant role and prime responsibilities are with grantee. Five-year grants

63. PARTICIPATING ITNEP SCHOOLS FY 2007 Duke University ( # 37263) –Collaborated with other universities to provide new information and skills to nursing faculty seeking to include advanced educational and clinical technologies into their curricula. Topical focus on distant learning, faculty development, informatics, interdisciplinary training, medical economics, patient safety/ medical errors, and telemedicine/ telehealth. University of Wisconsin- Madison ( # 37272) –Has a collaborative RN-BSN curriculum, created a faculty development model, provides faculty mentorship in new educational technologies, teaches faculty to use virtual reality, e-learning resources, mannequin-based and problem-based simulations. Topical focus on distant learning, faculty development, informatics, and telemedicine/telehealth. University of Wisconsin- Madison ( # 39897 ) –Created a collaborative faculty development model which includes simulated learning, informatics, and telehealth. University of Pittsburgh ( #39961) –Faculty development program focuses on teaching faculty skills in implementation, evaluation and dissemination of such learning technologies as telehealth, distance learning, informatics, and human simulation at the undergraduate and graduate levels.

64. ITNEP: ESTIMATED NUMBER OF FACULTY TRAINED FOR FY 2007 Participating SchoolsProj. Est. # of Faculty to be Trained Duke University75 University of Wisconsin-Madison30 University of Kansas Medical Center30-50 University of Pittsburgh30-50

65. PRESENTATION SUMMARY HRSA addresses the nursing faculty shortage through: AEN Nurse Educator Program grants AENT/NAT NFLP FDIT for Faculty Development In the NFLP program HRSA had 119 participating schools in 2007. Out of those 119 participating schools; the NFLP program had: 729 enrollees, 347 graduates, and 73 graduates employed in faculty positions.

66. PRESENTATION SUMMARY CONT. Summary of Outputs: Number of Participating Schools

67. United States Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions Division of Nursing National Council of State Boards of Nursing Faculty Shortage: Implications for Regulation Federal Funding Solutions Joan Weiss, PhD, RN, CRNP Acting Director Division of Nursing jweiss@hrsa.gov http://bhpr.hrsa.gov/nursing