IOWA ADVANCED PRACTICE NURSE TRACKING SYSTEM

Transcription

1 IOWA ADVANCED PRACTICE NURSE TRACKING SYSTEM ADVISORY COMMITTEE MEETING October, 05 Iowa Health Professions Tracking Center Office of Statewide Clinical Education Programs Carver College of Medicine The University of Iowa

2 Iowa Advanced Practice Nurse Tracking System Advisory Committee Meeting October, 05 0:00am :0am Carver College of Medicine 6 CMAB -Agenda- I. Welcome and Introductions II. Meeting Agenda and Participant List III. 0 Annual Report - Annual Benchmarks - Geographic Distribution - Trends - Workforce Comparison IV. Open Discussion Items

3 Iowa Advanced Practice Nurse Tracking System Advisory Committee October, 05 Advisory Committe Judith Collins, MA, ARNP Iowa Nurses Association Brenda Hoskins, DNP, MSN, ARNP, GNP-BC Iowa Nurse Practitioner Society Diane Huber, PhD, RN, FAAN, NEA-BC Professor University of Iowa College of Nursing Iowa Board of Nursing Kathy Weinberg, MSN, RN Executive Director Alternates: Jimmy Reyes, DNP, AGNP, RN Associate Director of Practice and Education Laura Hudson, RN, MSN Associate Director, CE/Workforce Kendra Williams-Perez, EdD, RN, CNE Professor and Dean, Allen College of Nursing Iowa Association of Colleges of Nursing Office of Statewide Clinical Education Programs Iowa Health Professions Tracking Center Theresa Dunkin Program Manager/Assistant Director Carole Kron Data Analyst/Assistant Manager Greg Nelson, MA, RN Assistant Dean for Clinical Education Programs Linda Thiesen Data Analyst/Assistant Manager K:\DOCUMENT\NP\YearEnd\0Yearend\GRAPHICS\AdvisoryCmteList.docx

4 Iowa APN Tracking System Advisory Committee Meeting September 0, 0 Advisory Group Members Present: Judith Collins Diane Huber Laura Hudson Jimmy Reyes Kendra Williams-Perez Kathy Weinberg Absent: Brenda Hoskins OSCEP Staff Present: Carole Kron Linda Thiesen Absent: Theresa Dunkin Called to order: 0:5 AM Adjourned: :0 PM Location: College of Medicine 6 CMAB Iowa City, IA 5 Prepared by: Linda Thiesen AGENDA DISCUSSION ACTION/DEADLINE/WHO II. Minutes Review of 9// meeting minutes; approved as submitted. III. Review 0 Annual Report A. Greeting & Introductions Theresa Dunkin and Brenda Hoskins are unable to attend today s meeting. B. Overview & History C. Kron briefly reviewed history of OSCEP/HPINV tracking system and data collection methods. Advanced Practice Nurses inventory officially began reporting in 999. K:\DOCUMENT\NP\YearEnd\0Yearend\0Minutes 9-0-.doc The APN Tracking System is a continuous inventory of all Iowa APNs, including CRNAs, Nurse Midwives and Certified Nursing Specialists.

5 AGENDA DISCUSSION ACTION/DEADLINE/WHO The purpose of this information is to describe the APN population, monitor trends, support and evaluate programs, etc. C. Annual Benchmarks,68 APNs identified at 0 yearend. C. Kron stated that data across all benchmark areas was consistent with previous year. Since 999, the annual increase in the active Iowa APN population has been 6-8% a year. The overall age of the APN population is younger. More APNs are continuing education to obtain an advanced degree immediately/soon after obtaining BSN, rather than returning to education after years in the workforce. Of the APNs leaving Iowa practice, 8% are identified as relocation (moving to another state). The number of female CRNAs has increased, with the gender split now 50/50 male-female. OSCEP will develop a new graphic showing the historical male-female CRNA numbers for the next meeting. OSCEP Forty counties have 50% or more APNs who are 50 years of age or older. A majority of these counties are located in the northern two tiers of counties and in the central and west counties in Iowa. K:\DOCUMENT\NP\YearEnd\0Yearend\0Minutes 9-0-.doc

6 AGENDA DISCUSSION ACTION/DEADLINE/WHO Review of State/UI Employees by age cohort reveals the 5% of this workforce segment are age 50 or older. Expansion of Community Health Centers, due to physicians not taking low income patients. Sixty-nine percent of APN workforce in primary care. D. Geographic Distribution APNs in Johnson, Scott, Linn and Polk counties make up 5% of the total workforce. CRNAs tend to practice in the smaller hospital markets. Larger population areas covered by anesthesiologists. E. Trends & Projections Projected growth through 00 was reviewed. Projections are based solely on historical yearend numbers. F. Workforce Comparisons The number of Iowa PA/NP practice opportunities has shifted due to many positions now open to either PAs or APNs instead of exclusively one or the other. Include an average age for psychiatry related specialties for physicians and APNs. OSCEP K:\DOCUMENT\NP\YearEnd\0Yearend\0Minutes 9-0-.doc

7 AGENDA DISCUSSION ACTION/DEADLINE/WHO IV. Discussion Items Interest in surveying practitioners to learn more about the effects of collaborative agreements and possible practice constraints. This effort is beyond the scope of the tracking system and would have to be conducted independently. K:\DOCUMENT\NP\YearEnd\0Yearend\0Minutes 9-0-.doc

8 IOWA APNs Annual Workforce Report* Date APNs December 0 8 January 0 70 Gain + 9 * For year ending --0 Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 05 K:Doc/NP/YE0/NP00.ppt

9 IOWA APNs Gender Distribution 0 Female 88% Male % Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 05 Female 590 Male Total 8 K:\DOC\NP\YE\0\Annual_Report\NP0.PPT

10 IOWA APNs Age Distribution 0 Age Category No. % Cumulative % < 0 6 5% 5% 0-9 % 59% % 85% > % 00% 8 00% >60 5% <0 5% % Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June % K:\DOC\NP\YE\0\AnnRpt\np8pie.PPT

11 IOWA APNs Full Time vs. Part Time* 0 Percent Full Time 67 9% Part Time 8% Total 8 00% *PT = < hours/week Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Medicine UI Carver College of Medicine, June 05 K:/DOC/NP/YE/0/Annual_Report/FTE-6.PPT

12 IOWA APNs Age Distribution Full Time vs. Part Time* 0 Age FT % PT % Cumulative % < > % *FT = > PT = < Source: University of Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 05 5 NP\YE0\AnnRpt\FTvPTage.PPT

13 IOWA APNs Detail of Age > APNs Age # in Iowa Total number of APNs age 50 and over = 79 (0%) Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 05 6 K:NP\YE0\AnnRpt\Over50-Bar-6.PPT

14 IOWA APNs Principal Professional Activity 0 Number Percent Private Practice % State Facility 7 9.5% Public/Community Health 95 5.% Federal 69.8% Teaching/Research.7% Hospital Medicine.7% Urgent Care 6 0.9% Student Health 0.8% Administration 0.% Total 8 00% Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 05 7 K:\DOC\NP\YE\0\Annual_Report\NP6.PPT

15 *CNS, CNS Med Surg, School NP, CNS Oncology, CNS Adult Health IOWA APNs Specialties 0 Number Percent Family NP (FNP) % RN Anesthetist (CRNA) 7.% Pediatric NP (PNP) 7.8% Ob/Gyn (ONP)/Women s Health 96 5.% Psychiatric NP (PSNP) 9 5.% Adult NP (ANP) 80.% Nurse Midwife (NMW) 5.0% Acute Care NP (ACNP) 5.9% Neonatal NP (NNP).9% Gerontological NP (GNP)/CGE.7% CNS Adult Psych (CAP) 8.0% Other* 5.9% CNS Child/Adolescent Psych, Perinatal NP Total 8 00% Source: Office of Statewide Clinical Education Programs, UI Carver College of Medicine Iowa Health Professions Tracking Center, June 05 8 K:\DOC\NP\YE\0\Annual_Report\NPSPEC.PPT

16 IOWA APNs Locations by Community Population 0 Cumulative Community Size APNs % % <5, ,000 -, ,000-9, >50, % Totals 8 00% Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 05 9 K:Doc/NP/YE/0YE/AnnualReport/0_.PPT

17 IOWA APNs Communities Gaining/Losing APNs 0 Community Size #Entering #Leaving <5,000 Net 5 + 5,000 -, ,000-9, >50, Total Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 05 0 K:Doc/NP/YE/0YE/AnnualReport/0-chart.PPT

18 IOWA ADVANCED PRACTICE NURSES (8) 0 Lyon Sioux 8 Plymouth 9 Woodbury 60 Monona 6 Harrison Osceola O'Brien Cherokee Ida Crawford 7 Pottawattamie Dickinson Shelby 5 9 Clay Buena Vista 8 Sac Audubon Palo Alto Pocahontas Carroll Cass Emmet 5 Calhoun Greene Guthrie 5 Adair Kossuth Humboldt Webster Boone 0 Dallas 8 Madison Winnebago Hancock 6 Wright 7 Hamilton 5 Story Polk 9 7 Warren Worth Cerro Gordo 0 Franklin Hardin Jasper 8 Marion Mitchell Marshall Floyd 6 Butler 6 Grundy Howard Chickasaw Black Hawk Tama Mahaska Bremer 6 Poweshiek 8 6 Winneshiek Allamakee Benton Keokuk 6 Fayette 9 Buchanan Iowa 5 Clayton Delaware Linn 5 Johnson 8 Washington 7 Dubuque Jones Cedar 69 Muscatine 7 Jackson 6 Clinton Scott 9 7 Mills Fremont Montgomery Adams Union Clarke Lucas Monroe Wapello Page Taylor Ringgold Decatur Wayne Appanoose Davis Jefferson Van Buren Henry 9 Lee 9 Louisa Des Moines KEY: 00+ () 0-99 () 6-9 (7) -5 (9) () 0 () Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 05 K:NP/YearEnd/0/Annual_Report/np0.cdr

19 IOWA APNs Family Nurse Practitioners (865)* 0 Lyon Osceola Palo Alto Winnebago Hancock Worth Mitchell 7 Sioux O'Brien 6 Dickinson Clay 9 Emmet 5 Kossuth 5 Cerro Gordo 6 Floyd Howard Chickasaw Winneshiek Allamakee 9 Fayette Clayton Plymouth 6 Woodbury Monona Harrison Cherokee 0 Mills Ida Pottawattamie Fremont Crawford Shelby Buena Vista Sac Montgomery Page Audubon Pocahontas Carroll Cass Calhoun Adams Taylor Greene Guthrie Adair 5 Humboldt Webster Union Ringgold Boone Dallas 8 Madison Hamilton Clarke Decatur Polk 8 Franklin Hardin Lucas Wayne Butler Grundy Monroe Black Hawk Tama Bremer Davis Benton Keokuk Van Buren 6 5 Story Warren 9 Marshall Jasper 6 Marion 8 *8% of Iowa s advanced practice nurses 5 Wright 6 Appanoose Mahaska 8 6 Poweshiek 9 Wapello Buchanan Iowa 6 Jefferson Delaware Linn 57 Washington 8 Johnson 5 Henry 5 8 Lee 8 Louisa Dubuque Jones Cedar Des Moines Muscatine 8 Jackson 5 Clinton 8 Scott 9 KEY: 0+ (9) 6-9 (6) -5 (5) (7) 0 (5) Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs Carver College of Medicine, June 05 K:Doc/NP/YE/0/np0.cdr

20 IOWA APNs Primary Care*: APNs (,67) and Physicians (,558) 0 Lyon Osceola / 0 / Sioux O'Brien 6/7 8/8 Dickinson 7/9 Clay /7 Emmet Palo Alto 5/5 Kossuth Winnebago Hancock Worth /6 / 0/ /7 5/ Cerro Gordo /78 Mitchell / Floyd /9 Howard / Chickasaw /0 Winneshiek Allamakee / /9 Fayette Clayton Plymouth 6/0 Woodbury 8/9 Monona 5/0 Harrison /7 Cherokee 0/5 Mills Ida Pottawattamie Fremont /8 8/59 0/8 / Crawford Shelby Buena Vista / /7 Sac / Montgomery Page Audubon Pocahontas Carroll 9/0 / Cass / / Calhoun / Adams Taylor Greene / Guthrie /6 Adair 5/ Humboldt / Webster 8/7 Union Ringgold Boone Dallas Madison Hamilton /6 /66 /7 Wright / 5/ /90 Clarke Decatur Polk Franklin Hardin 0/ Lucas Wayne Marshall Jasper 6/ Marion 8/ Butler Grundy 0/ / Monroe Black Hawk 9/ Tama Mahaska Bremer 0/9 Poweshiek Davis Benton Keokuk Buchanan Jefferson Van Buren / 8/ /0 / / 7/6 /8 /6 /8 Story /66 Warren / /8 0/5 /8 / /7 / Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs Carver College of Medicine, June 05 Appanoose /6 /7 Wapello /9 / Iowa Delaware Linn 9/88 Washington /7 8/8 8/9 Johnson 5/5 *Primary Care Specialties: APNs: ANP-80; FNP-865; GNP/CNS-Gero-; NMW-5; Ob-Gyn/WHNP-96; PNP- Physicians: Family Med (incl EM w/fm res)-55; Gen Int Med -57; Ob/Gyn-; Peds-6 /5 6/ / /9 / 7/7 /6 /9 Henry 7/ Lee Louisa / Dubuque Jones /8 Cedar /5 8/96 Muscatine /5 / Des Moines 7/6 Jackson 5/7 Clinton / Scott 67/6 KEY: APNs > Phys () K:Doc/NP/YE/0/Graphics/PrimaryCare.cdr

21 IOWA APNs Communities with APNs (08) 0 Larchwood Spirit Lake (6) Lake Mills () Cresco (6) Lake Park Estherville () Lansing Milford Armstrong () Boyden Okoboji Decorah () Sheldon (8) Graettinger Osage () Clear Lake () Waukon () Rock Valley Sioux Calmar () Center (7) Hartley Mason City (8) Spencer () Wesley Ossian Sanborn Britt () Garner () Emmetsburg () New Hampton () West Union () Orange City (7) Algona Elkader () Primghar Hawarden () Kanawha Belmond Charles City (5) Sumner () Arlington Guttenberg (7) LeMars (7) Pocahontas () Humboldt () Clarion (5) Rockford Allison Clarksville Oelwein () Cherokee () Hampton () Waverly () Edgewood Denver Kingsley () Storm Lake (8) Eagle Grove Shell Rock () Strawberry Point Moville Parkersburg Manson () Fort Dodge () Ackley () Independence Cedar Falls () Dubuque (67) Sioux City (56) Sac City Sergeant Bluff () Rockwell City Iowa Falls (5) Waterloo (97) Winthrop Evansdale Manchester (7) Webster City () Sloan Eldora Lake View Gowrie () Grundy Center () Jewell Hubbard () Cascade () Ida Grove () Bellevue Dayton Reinbeck Dysart Story City Monticello Lake City Ogden Marshalltown () Maquoketa (5) Mapleton () Boone (8) Zearing () Vinton Ames (6) Onawa () Denison (7) Carroll () Hiawatha (0) Shellsburg State Center Tama () Jefferson () Marion () Manning () Madrid Clinton () Dunlap Cedar Rapids (0) Audubon () Grimes Polk City Earling Panora () Ankeny (0) Grinnell (6) Marengo () Clarence Woodbine Guthrie Center Johnston () Newton (5) North Liberty () Coralville (0) Harlan () Urbandale () Altoona () Montezuma () Tipton LeClaire Adair Waukee () Prairie City Iowa City () West Branch Windsor Heights () New Sharon Williamsburg Clive (7) Pleasant Hill Sully () Wellman Wilton Bettendorf () Davenport (7) Atlantic (8) W Des Moines (56) North English Muscatine (6) Shelby Stuart () Des Moines (8) Pella (7) Underwood Sigourney () Fontanelle Pleasantville Washington () Council Bluffs (5) Indianola () Knoxville (7) Wayland Columbus Greenfield () Melcher-Dallas City Carson Oskaloosa () Winfield Winterset () Eddyville () Creston (7) Mount Pleasant (6) Corning Osceola () Ottumwa () Fairfield () Red Oak (5) Chariton (5) New London Humeston Albia () West Burlington () Shenandoah (9) Villisca Corydon () Leon () Bloomfield (0) Keosauqua () Burlington () Clarinda () Mount Ayr () Sidney () Seymour () Centerville () West Point Hamburg () Bedford () Lamoni () Lineville () Fort Madison () Keokuk (6) Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 05 NP\Yearend\0\NP0_Comm.CDR

22 Lyon Sioux IOWA APNs Certified Registered Nurse Anesthetists () 0 Osceola O'Brien Dickinson Clay Emmet 7 Palo Alto Kossuth Winnebago Hancock Worth Cerro Gordo Mitchell Floyd Howard Chickasaw Winneshiek Allamakee Fayette Clayton Plymouth Woodbury Monona Harrison Cherokee Ida Pottawattamie 7 Crawford Shelby Buena Vista Sac Audubon Pocahontas Carroll Cass Calhoun Greene Guthrie Adair Humboldt Webster 6 Boone Dallas Madison 7 Wright Hamilton Story Polk 9 Warren Franklin Hardin Marshall Jasper Marion Butler Grundy Black Hawk Tama Mahaska Bremer Poweshiek 6 Benton Keokuk Buchanan Iowa Delaware Linn Johnson Washington Louisa Dubuque 7 Jones Cedar Muscatine 6 Jackson Clinton Scott Mills Fremont Montgomery Page Adams Taylor Union Ringgold Clarke Decatur Lucas Wayne Monroe Appanoose Wapello Davis 7 Jefferson Van Buren Henry Lee Des Moines 6 KEY: CRNAs Counties > (5) 6-0 () - 5 () - 0 () (7) Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 05 5 K:Doc/NP/YE0/CRNA-Cty.cdr

23 IOWA APNs Communities with CRNAs (65) 0 Spirit Lake () Estherville Osage Sheldon () Mason City () Orange City () Spencer (7) Algona LeMars () Cherokee Sioux City () Clarion () Hampton Storm Lake () Ida Grove Fort Dodge (6) Iowa Falls Cresco () Decorah () Waukon () New Hampton Charles City () West Union () Guttenberg () Waverly () Dubuque () Manchester (7) Waterloo (6) Grundy Center Lake City Boone (7) Marshalltown (0) Onawa Denison () Carroll () Ames Jefferson Manning Panora* Grinnell () Newton () Des Moines (8) Atlantic () W Des Moines () Pella () Council Bluffs (7) Knoxville () Creston () Corning Red Oak () Shenandoah () Hamburg Winterset Chariton Albia Leon Bloomfield (7) Oskaloosa () Maquoketa Iowa City (5) Davenport () Muscatine (6) Mount Pleasant West Burlington (6) Fort Madison () *Locum Tenens Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 05 6 NP\Yearend\0\NP0-CRNA_Comm.CDR

24 IOWA APNs Psychiatric Nurse Practitioners* (7) 0 Lyon Osceola Dickinson Emmet Kossuth Winnebago Worth Mitchell Howard Winneshiek Allamakee Sioux Plymouth Woodbury CAP- CCAP- PSNP- Monona Harrison O'Brien Cherokee PSNP- Ida Crawford Pottawattamie CAP- PSNP- Shelby CAP- Clay CAP- PSNP- Buena Vista PSNP- Sac Audubon Palo Alto Pocahontas Carroll Cass PSNP- Calhoun Greene Guthrie Adair Humboldt Webster Boone Dallas PSNP- Madison Hancock PSNP- Wright Hamilton Story PSNP- Polk CAP- CCAP- PSNP- Warren Cerro Gordo PSNP-5 Franklin Hardin Marshall PSNP- Jasper Marion PSNP- Floyd Butler Grundy Chickasaw Black Hawk Tama Mahaska Bremer Poweshiek PSNP- PSNP- PSNP- PSNP-6 Benton Keokuk Fayette Buchanan Iowa Clayton Delaware Linn CAP- PSNP- Johnson CAP-6 CCAP- PSNP-8 Washington PSNP- Louisa Dubuque Jones Cedar PSNP- Muscatine Jackson Clinton PSNP- Scott CAP- CCAP- PSNP-8 Mills Fremont Montgomery Page CCAP- PSNP- Adams Taylor Union Ringgold Clarke Decatur PSNP- Lucas Wayne Monroe Appanoose Wapello PSNP- Davis Jefferson Van Buren Henry CAP- Lee PSNP- Des Moines KEY* PSNP CAP CAP/PSNP CAP/CCAP/PSNP *PSNP-Psychiatric NP; CAP-CNS Adult Psych; CCAP-CNS Child/Adolescent Psych Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 05 7 K:DOC/NP/YE/0/PsychNP.cdr CCAP/PSNP CAP-8; PSNP-9; CCAP-5

25 IOWA APNs Psychiatric Nurse Practitioners and Psychiatrists 0 Lyon Osceola Dickinson Emmet Kossuth Winnebago Worth Mitchell Howard Winneshiek Allamakee Sioux O'Brien 0/ Clay /0 Palo Alto Hancock /0 Cerro Gordo 5/ Floyd Chickasaw 0/ Fayette Clayton Plymouth Woodbury /8 Monona Harrison Cherokee / Ida Crawford Shelby /0 Buena Vista /0 Sac Audubon Pocahontas Carroll Calhoun Greene Guthrie Humboldt Webster 0/ Boone Dallas / Wright Hamilton Story /5 Polk 6/7 Franklin Hardin 0/ Marshall / Jasper Butler Grundy Tama Bremer Poweshiek / / Black Hawk 6/0 Buchanan Benton Iowa 0/ Delaware Linn Johnson /0 / 5/79 Dubuque Jones Cedar /6 Muscatine Jackson Clinton /0 Scott 0/7 Pottawattamie Cass Adair Madison Warren Marion Mahaska Keokuk Washington /5 / /0 / Louisa Mills 0/ Fremont Montgomery Page Adams Taylor Union Ringgold Clarke Decatur Lucas Wayne Monroe Appanoose Wapello Jefferson / 0/ Davis Van Buren Henry / Des Moines 0/5 KEY: / /0 0/ Lee / Psych > APNs (0) APNs > Psych (6) First Number is APN/second is psychiatrist Average Age: Total APNs: 7 Psychiatrist - 5 Total Psychiatrists: 6 Psych NP - 50 Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 05 8 Psych Only-No APNs (9) APNs Only-No Psych (8) APNs = Psych (5) No Psych or APN (6) K:\Doc\NP\YE0\PsychAPN-Phys.cdr

26 IOWA APNs Age 50 and Over 0 Lyon Osceola Dickinson Emmet 0/ 5/9 / Sioux O'Brien Clay Palo Alto /8 6/ / /5 Kossuth / Winnebago / Hancock /6 Worth Cerro Gordo /0 Mitchell / Floyd /6 Howard /6 Chickasaw / Winneshiek /6 Fayette Allamakee /5 Clayton Plymouth Cherokee Buena Pocahontas Humboldt Wright Vista Franklin Butler Bremer /9 7/ /8 0/ 0/ /7 0/ 0/6 Webster Woodbury Ida Sac Calhoun Hamilton Hardin Grundy 0/ 6/60 / / / 0/ /5 / Black Hawk Buchanan Delaware Dubuque 6/ / /7 /69 Tama Benton Linn Jones Monona Crawford Carroll Greene Boone Story Marshall 0/ 8/5 0/ /6 /7 / / 5/0 /9 6/ 0/ 6/6 /9 6/ Harrison Shelby Audubon Guthrie Dallas Polk Jasper Poweshiek Iowa Johnson 0/ /5 / 5/5 7/8 8/7 /8 / /8 0/ /8 76/69 Pottawattamie Cass Adair Madison Warren Marion Mahaska Keokuk Washington Cedar / Muscatine 5/7 Jackson /6 Clinton 6/ Scott 5/9 st number > 50 years of age / nd number = total in county Source: /7 Mills Fremont /5 Montgomery /6 Page 0/ /8 Adams / Taylor / /5 Union /7 Ringgold / Clarke Decatur /6 Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 05 / 0/ 7/6 7/5 0/ 0/ 0/ Lucas /5 Wayne /7 Monroe / Appanoose / Wapello /5 Davis /0 9 Jefferson / Van Buren / Henry /9 Lee 7/9 Louisa 0/ Des Moines / > 50% age 50 and over (5) < 50% age 50 and over (6) = 0 APNs () NP\YE\0\AnnReport\NP08.cdr

27 ACTIVE IOWA APNs % Increase '99 '00 '0 '0 '0 '0 '05 '06 '07 '08 '09 '0 ' ' Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 05 0 ' ' K:/Doc/NP/YE/0YE/NP0.PPT

28 IOWA ADVANCED PRACTICE NURSING SUPPLY All APNs Primary Care APNs* Nurses APNs Primary Care APNs APN Supply 86% Increase '99 '00 '0 '0 '0 '0 '05 '06 '07 '08 '09 '0 ' ' ' ' Primary Care APNs* 5% Increase 8 67 *Primary Care: ANP, FNP, GNP/CGE, NMW, ONP, PNP, WHNP Source: Office of Statewide Clinical Education Programs, UI Carver College of Medicine Iowa Health Professions Tracking Center, June 05 K:\doc\PIS\05 document\greg\09505 letter APN Trendline.ppt

29 IOWA APNs Net Gain/Loss APNs '99 '00 '0 '0 '0 '0 '05 '06 '07 '08 '09 '0 ' ' ' ' Entering Leaving Net Gain/Loss Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 05 K:Doc\NP\YE\0YE\NP68.PPT

30 IOWA APNs Age Distribution Comparison 999 vs Under and Over *Includes unknown Year Total APNs Average Age Median Age * 5 5 Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 05 K:Document\NP\0YrEnd\70.PPT

31 IOWA APNs Working in Communities of <5, All APNs <5,000 Comm '99 '00 '0 '0 '0 '0 '05 '06 '07 '08 '09 '0 ' ' ' ' 570 Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 05 K:/DOC/NP/YE//0/Annual_Report/Comm5KNP0.ppt

32 Towns with APNs IOWA APNs Towns With at Least One APN '99 '00 '0 '0 '0 '0 '05 '06 '07 '08 '09 '0 ' ' ' ' 7 Year Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June % Increase 08 K:/DOC/NP/YE/0/Annual_Report/NPS06.ppt

33 0% Decrease 5% Increase Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 05 6 K:/DOC/NP/YE/0/Graphics/NPS06 w PHY

34 IOWA HEALTH PROFESSIONS INVENTORY Composition of Workforce - 0 Physicians 57 Pharmacists 89 Dentists 58 Nurse Practitioners 8 Physician Assistants 85 Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 05 7 K:\DOC\NP\YE\0\IAWorkforceSum

35 IOWA HEALTH PROFESSIONS INVENTORY '0 '0 '05 '07 '09 ' ' ' Physicians 9% Increase Pharmacists 7% Increase APNs 5% Increase Dentists 0% Increase PAs 7% Increase Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 05 8 K:\Doc\NP\YE0\GRAPHICS\HP-comptrend.PPT

36 IOWA HEALTH PROFESSIONS INVENTORY Composition of Workforce - 0 Net Gain/Loss Summary Entering % Leaving % Net % Total Physicians 67 6.% 0 7.0% % 57 Pharmacists 77 6.% 9 6.6% % 89 Dentists 69.5% 9 6.0% - -.6% 58 Nurse Practitioners 7.0% 5 6.9% 9 5.% 8 Physician Assistants % 5 5.5%.5% 85 Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 05 9 K:Document/NP/0YrEnd/IAWorkforceSum_NetGain_Loss.PPT

37 IOWA HEALTH PROFESSIONS INVENTORY Composition of Workforce - 0 Gender Male % Female % Total Physicians 066 7% 667 9% 57 Physician Assistants 9% 58 7% 85 Dentists 7 7% 0 6% 58 Pharmacists 09 8% 80 6% 89 APNs % % 8 Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 05 0 K:Doc/NP/YE0/Graphics/HP-Comp-GENDER_0.PPT

38 IOWA HEALTH PROFESSIONS INVENTORY Composition of Workforce 0 Age Physicians Physician Assistants Dentists Pharmacists APNs <0 0 % 9 8% 7 % 6 % 6 5% % 78 % 9 9% 700 % % % 76 % 5 % 587 0% 6 6% > 60 % 78 9% 06 6% 8 % 66 5% Total Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 05 K:DOC/NP/YE0/IA-WF-Sum-AGE

39 IOWA HEALTH PROFESSIONS INVENTORY Composition of Workforce - 0 Retirement Summary Average Average Retired % Leaving Age Retirement Age Physicians % Pharmacists 6 % 9 66 Dentists 5 5% Nurse Practitioners 0 6% Physician Assistants 7 5% 6 6 Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 05 K:Document/NP/0YrEnd/IAWorkforceSum_retirement.PPT

40 IOWA HEALTHCARE POPULATION MD/DO APN PA 0 PA = 0% (85) PA = % (65) APN = % (,8) APN = 9% (,67) MD/DO = 68% (5,7) Total 8,70 MD/DO = 60% (,558) Total,90 % of All Health Professionals % of Primary Care* Health Professionals *Primary Care includes residency-trained FM physicians practicing EM, Family Medicine, General Internal Medicine, General Pediatrics, & Obstetrics/Gynecology Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 05 K:Doc/NP/YE-0/Graphics/ia workforce55 all professions.ppt

41 IOWA HEALTH PROFESSIONS INVENTORY Distribution by Community Size 0 Community Population No. of Communities With Providers No. of Providers % of Providers APNs Phys PA APNs Phys PA APNs Phys PA <,000 5.% 0.%.8%,000-, ,000-9, ,000-9, ,000-99, > 00, Total % Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 05 K:Doc/NP/0YrEnd/IA Workforce Community DistPPTX