GENERAL ASSEMBLY OF NORTH CAROLINA

1987 SESSION

 

 

CHAPTER 1049

HOUSE BILL 2461

 

AN ACT TO ADDRESS THE NURSING EMERGENCY WHICH IS FACED BY NORTH CAROLINA.

 

The General Assembly of North Carolina enacts:

 

Section 1.   Existing scholarship and loan information consolidated and published.  (a) The State Education Assistance Authority of the Board of Governors of The University of North Carolina shall consolidate information on existing scholarships and loan programs available for nursing education. The information shall be published in a brochure and made available to high schools, colleges, Area Health Education Centers, and other facilities.

(b)       There is appropriated from the General Fund to the Board of Governors of The University of North Carolina the sum of twenty thousand dollars ($20,000) for the 1988-89 fiscal year for the State Education Assistance Authority to implement subsection (a) of this section.

Sec. 2.  Emergency Financial Assistance Fund.  (a) There is established an Emergency Financial Assistance Fund for students in State educational nursing and licensed practical nursing programs, to be administered by each campus.  Emergency need is defined as acute financial need caused by a particular event which immediately and severely impacts a particular student's ability to continue his or her educational program in nursing on that student's current schedule.  Allowable expenses, for emergency assistance, shall include funds for child care, transportation, housing, and medical care; and shall not be considered as an ongoing source of income for those expenses. Emergency assistance shall be limited to four hundred dollars ($400.00) per academic year for any individual. The local Board of Trustees at each campus shall review quarterly the expenditures under this Fund, and the Department of Community Colleges and the Board of Governors of The University of North Carolina shall assess the Fund's impact on completion rates in these programs, and report their assessment to the General Assembly.

(b)       There is appropriated from the General Fund to the Department of Community Colleges the sum of four hundred ten thousand dollars ($410,000) for the 1988-89 fiscal year and there is appropriated from the General Fund to the Board of Governors of The University of North Carolina the sum of one hundred forty thousand dollars ($140,000) for the 1988-89 fiscal year for the Emergency Financial Assistance Fund.  These funds shall be allocated among the institutions with nursing programs, based on policies adopted by the State Board of Community Colleges and the Board of Governors of The University of North Carolina.

Sec. 3.  Nursing licensing exam follow-up assistance.  The Board of Governors of The University of North Carolina shall direct the constituent institutions and the State Board of Community Colleges shall direct the Community Colleges to provide follow-up assistance for their students who fail the nursing licensing exam for the first time.  This follow-up assistance shall include consultation with the Board of Nursing on areas needing improvement and shall include providing additional appropriate preparation assistance before the next exam date.

Sec. 4.  Drop-out exit surveys.  The Board of Governors of The University of North Carolina shall direct the constituent institutions and the State Board of Community Colleges shall direct the Community Colleges to conduct an exit survey of students who drop out of nursing programs to determine their reasons for leaving the programs.  This survey data shall be reported to the Study Commission on Nursing along with recommendations on how to reduce the number of students who do not complete the nursing programs.

Sec. 5.  AHEC publicity program.  The Area Health Education Centers of The University of North Carolina and the Board of Nursing shall cooperate in developing publicity on:

(1)       New salary levels and job opportunities in nursing;

(2)       The availability of refresher courses; and

(3)       License renewal requirements for registered nurses whose licenses are not currently active. 

This information shall be provided to nurses without a current license in an effort to attract them back into nursing practice.

Sec. 6.  AHEC nursing study.  The Area Health Education Centers Program of The University of North Carolina shall study nurses who leave their jobs, in order to provide data to the Legislative Study Commission on Nursing on the reasons nurses leave their jobs and if the nurses plan to continue practicing nursing in other jobs.  This data shall be used by the Legislative Study Commission on Nursing to identify positive retention factors for nurses and to formulate strategies for changing work environments in order to attract nurses back into the profession.

Sec. 7.  Legislative Study Commission on Nursing.  (a) There is established the Legislative Study Commission on Nursing.  The Commission shall be composed of four members of the Senate appointed by the President of the Senate and four members of the House of Representatives appointed by the Speaker of the House, and six members of the public, three appointed by the Speaker of the House and three appointed by the President of the Senate.  The Speaker of the House of Representatives and the President of the Senate shall each appoint one member as cochairman of the Commission.  Members of the Commission shall receive per diem and travel allowances as authorized under G.S. 120-3.1 for members who are legislators and G.S. 138-5 for members who are not legislators. 

(b)       The Commission is charged to study the issues outlined below.  The Commission shall make recommendations, including cost estimates, aimed at impacting the nursing shortage.

(c)       The Commission shall make a final report of its recommendations to the General Assembly by April 1, 1989.

(d)       The Commission may, with the approval of the Legislative Services Commission, meet in the State Legislative Building or the Legislative Office Building.  The Commission will use the staff of the General Assembly to the extent authorized by the Legislative Services Commission.  Clerical assistance will be furnished by the General Assembly.  The Commission may enter into contracts, if needed, with consultants after obtaining permission from the Legislative Services Commission.

(e)       The Commission shall study the following issues and other issues which relate to the shortage of nurses:

Education-Related Issues

(1)       The need for a merit scholarship program for nursing, modeled on the Teaching Fellows Program.  If the Commission finds a need, it shall plan and develop a program for submission to the General Assembly.  This shall be the Commission's top priority.

(2)       The need for need-based scholarship programs, loan programs, or other forms of financial assistance that would improve the number of students completing nursing education.  If the Commission finds a need, it shall plan and develop a program for submission to the General Assembly. 

(3)       The need for additional support services for nontraditional students going into nursing; such as  counseling and peer tutors, in State-funded nursing programs.

(4)       The need to improve articulation for graduates of Associate Degree programs into Baccalaureate nursing programs in The University of North Carolina and private colleges.

(5)       The need to increase AHEC off-campus Baccalaureate nursing programs in rural areas.

(6)       The need for incentives or grants for employers to encourage nurses to participate in further education.

(7)       The need for the public schools to incorporate health occupations curricula into courses acceptable for meeting college entrance requirements.

(8)       The need for development of alternative teaching sites, such as nursing homes, for more exposure to students and for continuing education.

Retention-Related Issues

(9)       The need and feasibility for a Center for Excellence in Nursing, as an incentive and reward for excellence in direct patient care.  The Center could be modeled on the Center for the Advancement of Teaching.  The Commission may begin planning for such a Center, if it deems it appropriate.

(10)     A plan to develop a statewide media effort (in conjunction with schools, employers, and others) to further enhance the image of the nursing profession, showing its value and contributions to society.

(11)     The need for providing competitive grants to employers to develop innovative pilot programs to retain nurses in direct patient care services.

(12)     The development of information and strategies for improvement of the work environment for nurses.  These may include many of the efforts already under study by various AHEC's, including:

a.         Review of successful "magnet" hospital efforts,

b.         Professional practice models,

c.         Management and leadership training,

d.         Internships, and

e.         Consulting services for employers.

(13)     The need for regulation of nursing pools, including issues on responsibility for meeting certain minimum standards and certifying that credentials of nurses in the pool are adequate.

Recruitment-Related Issues

(14)     Ways to encourage students in the public schools, and in college, to enter health careers including a statewide recruitment strategy and enhancement of health career programs.

(15)     The development of innovative strategies for recruitment into the profession for service in rural and other shortage areas and strategies for recruitment from targeted groups such as persons beginning second careers, minorities, and persons in related fields.  Some options that may be considered include nursing residencies in rural hospitals, clinical settings in nursing homes, and incentive pay or bonuses for work in rural areas.

(16)     The need for an Office of Nursing and Allied Health as a central point for dissemination of information on these professions to students, professionals, employers, and others.

Salary-Related Issues

(17)     The applicability of cafeteria benefits options to the nursing shortage.

(18)     The impact of Medicaid reimbursement rates and rate setting methodology on the ability of employers to meet salary requirements of the nursing staff.

(19)     The need to develop a budget strategy to provide advance information to the General Assembly on funds required to pay for pending range revisions and other salary requirements caused by changing labor market conditions.

(f)        The Commission shall monitor the implementation of a nurse aide registry as required by Federal PL 100-203.  The Commission shall report to the General Assembly on the need for legislation, if any, to carry out the Federal requirements.

Sec. 8.  There is appropriated from the General Fund to the General Assembly the sum of fifty thousand dollars ($50,000) for the 1988-89 fiscal year for the operations of the Legislative Study Commission on Nursing created by Section 7 of this act.

Sec. 9.  This act shall become effective July 1, 1988.

In the General Assembly read three times and ratified this the 5th day of July, 1988.