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 HPEC Advocacy: Solutions 

Solutions to Rapidly and Cost-Effectively Reduce Shortages of Health Care Workers, Ensure Patient Safety, and Meet Health System Change Projections

What Can Congress Do?

Direct a proportionate share of federal support to nursing programs at community colleges.
Community colleges educate the majority of RNs and do so more cost-effectively and efficiently. An ADN student at a public community college pays $6,120 in tuition and fees compared with costs of $10,528–$21,960 to earn a BSN at a public 4-year college. Generally, the BSN requires at least 120 credit hours and the ADN requires 71.5 credit hours. Despite their savings and efficiencies, community college schools of nursing receive only a fraction— just 2% in 2010—of the Public Health Service Act Title VIII Nursing Workforce Development program funding to support undergraduate nursing. In plain terms, in FY 2010 ADN programs received 1 out of every 40 nursing-related Title VIII grant investments.

Make community colleges eligible for participation in federally funded programs targeted at increasing RN program enrollments to bolster the nursing workforce.
While community colleges experience the greatest demand for RN program admissions, the federally funded Nurse Education, Practice, Quality and Retention funding for the purpose of expanding enrollments exclusively supports expansion of BSN programs.

Make advancing ADN-prepared RNs to master's level nursing programs a key strategy in proposals to strengthen and stabilize the nursing workforce, including to address the faculty shortage.
Without additions to the nursing faculty and primary care workforces, the nation cannot meet the health care needs of its citizenry. Approximately 173 graduate-level nursing programs enroll and educate ADN-prepared RNs to serve in faculty, primary care provider and other advanced nursing roles. Nearly 21% of ADN-prepared RNs continue their education to attain a second nursing degree but most only attain a BSN, which does not prepare nurses for responsibilities beyond the RN level.

Strengthen the efforts of federally funded national health care workforce advisory groups through community college participation.
Community colleges are the predominant resource ensuring the development of a diverse health care workforce in all communities of our nation, including those in rural and urban areas that traditionally are underserved. Moreover, these professionals are the engines of the nation's largest industrial complex, the health care industry, generating the leading share of the U.S. gross domestic product at 17.3% in 2009. Absent community college experts serving on national health care workforce groups, a bias in a group's expertise could be created. Such a void diminishes each commission's potential in assessing whether the demand for health care workers is being met.

What Can State Legislatures Do?

Ensure that state regulations and laws recognize the single scope of practice that exists for all RNs.
For more than 50 years, ADN-prepared RNs have demonstrated their competencies by passing the RN licensure exam, and they do so with pass rates comparable to those of their BSN-prepared counterparts. Federal data demonstrate that ADN- and BSN-prepared RNs serve at about the same percentage in leadership roles in management or administration positions and in public or community settings. Furthermore, employers are equally likely to hire ADN- and BSN-prepared RNs, and employment in hospitals does not vary significantly by the type of degrees RNs hold.

Provide state funding to community colleges to increase the number of graduates by expanding health program capacity. State support constitutes a significantly higher percentage of community college budgets than it does for the budgets of 4-year institutions.
Community colleges are turning qualified students away from health professions programs, a trend likely to continue as tuitions increase at 4-year institutions, shortages of faculty grow, and the nation's demand increases.

Include ADN-prepared RNs—poised and eligible for direct enrollment in graduate nursing programs—in efforts to expand the nursing faculty and nurse practitioner workforces.
The nation's need for nursing faculty and nurse practitioners (primary care providers) could be met if just a fraction of the 21% of ADN-prepared RNs who opt to attain a second nursing degree graduated from the nation's existing 173 RN to MSN programs.

Make community colleges eligible for participation in all state-funded programs enabling nursing and allied health program expansions.
Community colleges provide the most efficient and cost effective means of educating high-quality nurses and allied health professionals.

What Can Hospitals and Other Health Care Providers Do?

Facilitate nurses and allied health professionals serving as faculty in classroom and clinical settings and provide clinical sites and other resources to support community college nursing and allied health programs.
Partnerships focused on removing barriers, including lack of clinical education facilities and preceptors (clinical faculty) and faculty for classroom teaching, are key to community colleges' ability to increase nursing and allied health program enrollments and graduations.

Ensure that RNs graduating from all program types are equally valued.
While different types of institutions educate RNs, all RNs share a single scope of practice and preparation.

Encourage RNs to adopt lifelong learning to advance academically in graduate-level programs that provide skills beyond the RN-level.
Nursing programs must have nursing faculty to ensure the availability of RNs to meet each community's health care needs. RNs must be encouraged to and supported in achieving graduate-level education through RN to MSN programs where competencies are expanding beyond the RN level.

Partner with community colleges to secure funding to grow the nation's health professions workforce.
Congress has provided federal programs to allow hospitals to partner with colleges to address health care workforce challenges. Similar investments from state and foundation entities are supporting partnerships to address local and state health care workforce needs.

Share board representation: serve on community college boards and ensure that community college representatives serve on hospital boards.
By working together, community colleges, hospitals and health care organizations can develop and implement community solutions.

Recruit high school students and others into health care careers.
Collaborate with community colleges to increase awareness in secondary schools of the nursing and allied health professions.

Share your data about current employees and projected need.
Community colleges are poised to meet local workforce needs, which require data to support program planning.

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