Joan Weiss, PhD, RN, CRNP Acting Director Division of Nursing March 26, 2008

1. 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 United States Department of Health and Human ServicesHealth Resources and Services Administration Bureau of Health Professions

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, master’s 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: • 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 • Master’s and Doctoral programs • Combined RN/Master’s programs • Post-nursing Master’s 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 master’s degree, post-master’s 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 master’s 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 EDUCATORFUNDING 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 PREPAREQUALIFIED 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 PREPAREQUALIFIED 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 notallowable • 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. ELIGIBLE STUDENTS Students must also be: • Pursuing a Master’s or doctoral degree, a combined RN to Master’s degree, a nurse-midwifery certificate, or a post-nursing Master’s 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

34. NURSE ANESTHESIA TRAINEESHIP PROGRAM (NAT)

35. PURPOSE • Authorizes grants to meet the costs of traineeships for licensed registered nurses enrolled as full-time studentsbeyond the twelfth month of study in a master’s 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. NURSE FACULTY LOAN PROGRAM ELIGIBILITY • 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.

42. NURSE FACULTY LOAN PROGRAM ESTABLISHMENT • 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.

43. NURSE FACULTY LOAN PROGRAM ESTABLISHMENT (CONT.) 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 master’s 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.

44. NURSE FACULTY LOAN PROGRAM BENEFICIARY ELIGIBILITY 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

45. NURSE FACULTY LOAN PROGRAM BENEFICIARY ELIGIBILITY 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 1st , 2nd and 3rd year of employment as full-time faculty; and • 25% cancellation upon completion of the 4th year of employment as full-time faculty.

48. NURSE FACULTY LOAN PROGRAM INTEREST RATE 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

49. NURSE FACULTY LOAN PROGRAM INTEREST RATE 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