How To Change The Law On Nursing

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1 Impact Analysis- Proposed Rule Change 21 NCAC Faculty Agency: North Carolina Board of Nursing (NCBON) Contact: Polly Johnson, Executive Director X250 Rule Title: 21 NCAC Faculty State Impact: Yes Local Impact: No Substantial Economic impact: No Summary of the Proposed Revision: 1. Article 9A Nursing Practice Act of chapter 90 of the General Statutes authorizes the Board of Nursing to promulgate and revise rules related to faculty qualifications as follows: N.C. GS (b) (8) empowers the Board of Nursing to Establish standards to be met by the students, and to pertain to faculty, curricula, facilities, resources, and administration for any nursing programs as provided in GS N.C. GS (a) further states that. The Board shall establish, revise, or repeal standards for nursing programs. These standards shall specify program requirements, curricula, faculty, students, facilities, resources, administration and describe the approval process. Those standards shall be designed to ensure that graduates of those programs have the education necessary to safely and competently practice nursing. 2. The current rule 21 NCAC (e) (1) requires nursing faculty who teach in a program leading to initial licensure as a nurse to hold either a baccalaureate in nursing or a master s degree in nursing from an accredited institution. 3. The NC Board of Nursing proposes to amend this rule to require all nursing faculty initially employed after December 31, 2015 to also meet the standards for faculty preparation as set by a national nursing accreditation body recognized by the United States Department of Education. {see definition in 21 NCAC (29)} The proposed rule revision would read as follows: 21 NCAC (e) Nursing faculty who teach in a program leading to initial licensure as a nurse shall:. (7) if initially employed after December 31, 2015, meet standards established by a nursing accreditation body as defined in 21 NCAC (29). * *NOTE: Current National Accreditation Body Faculty Standards for Associate Degree (ADN) and Practical Nursing (PN) Education Programs are set by NLNAC as follows: 1

2 For ADN programs - Faculty and Staff: 2.1 Full-time faculty are credentialed with a minimum of a master s degree with a major in nursing and maintain expertise in their areas of responsibility The majority of part-time faculty are credentialed with a minimum of a master s degree with a major in nursing; the remaining part-time faculty hold a minimum of a baccalaureate degree with a major in nursing Rationale is provided for utilization of faculty who do not meet the minimum credential. For PN programs - Faculty and Staff: 2.1 At least 50% of the full-time faculty who provide didactic instruction hold a graduate degree in nursing. The remaining full-time faculty members hold a minimum of a baccalaureate degree in nursing The majority of part-time faculty are credentialed with a minimum of a master s degree with a major in nursing; the remaining part-time faculty hold a minimum of a baccalaureate degree with a major in nursing Rationale for the acceptance of other than the required graduate credential is provided by evidence of one of the following: progress towards a graduate degree in with a major in nursing; current course work; related continuing education; or certification relevant to the current teaching role. 4. The purpose of the rule change is to strengthen the capacity of nursing programs by assuring that faculty standards support the preparation of a future nursing work force that is better prepared to meet the challenges of North Carolina s changing population and the technological demands of patient care in the years ahead. (See recommendations in NC Institute of Medicine s 2004 Task Force Report on the Future Nursing Workforce in North Carolina) The proposed change supports the Board of Nursing s mandate in GS (2) that standards shall be designed to ensure that graduates of those programs have the education necessary to safely and competently practice nursing. Basic Economic Impact of Proposed Rule Revision: 1. Basic Assumptions: With the implementation date of the rule being January 1, 2016, the following basic assumptions are being made in the estimation of the impact of the rule revision: Cost estimates are based on current costs National accreditation body standards for faculty preparation are projected to be the same in 2016 as they are today. See above. (NOTE: The above referenced 2

3 NLNAC standards were most recently released in March There has not been significant change in faculty standards in the last 20 years.) Pending revisions to Rule 21 NCAC require all programs to achieve national accreditation by 12/31/2015. Assuming this rule does take effect, proposed changes to this rule (21 NCAC ) will not cause any real world economic impact beyond Rule 21 NCAC By 12/31/2015, percentage of non- masters prepared faculty will be less than current numbers due to the number of faculty currently enrolled in graduate study, the increased availability of MSN programs in NC, and the increased funding of scholarship and financial aid available from federal, state and private entities. Costs for obtaining the MSN degree are the responsibility of the individual faculty member. Rule 21 NCAC pertains to all prelicensure nursing education programs in North Carolina. Completion of these programs leads to initial licensure either as a registered nurse (RN) or as a licensed practical nurse (LPN). Prelicensure nursing programs in North Carolina fall under one of three structures: (1) UNC Board of Governors; (2) North Carolina Community College System (NCCCS), or (3) Private. The NCCCS offers both Associate Degree programs that lead to RN licensure and Practical Nursing programs that lead to LPN licensure. Nursing programs in NC that are already nationally accredited meet the proposed rule revision. These programs will not be fiscally impacted and, thus, are not addressed in this fiscal note. FY vacancy rates and percent of faculty with master s degrees are used as the basis for the estimates for This analysis assumes that there will be no changes to current state policies, including the cost of tuition or availability of financial aid. This analysis also assumes that there will be no expansion in the existing nursing program enrollment capacity, and therefore there will be a static teaching population. 2. State Impact: All of the programs within the UNC system as well as all private registered nursing programs currently meet the proposed faculty requirements. Nine (9) Associate Degree Nursing programs within the NCCCS currently meet these proposed faculty requirements. Faculty data utilized for this impact statement comes from data provided in the annual report of nursing education programs to the NC Board of Nursing, as required in 21 NCAC (f) Reports and Records, for November 1, Financial data is referenced to source in the narrative. NC Community Colleges System There are 38 Associate Degree Nursing (ADN) programs and 36 Practical Nursing (PN) programs within the NCCCS that would be impacted by this proposed rule revision. According to information received from NCCCS in 2007, 3

4 the average salary for a full-time BSN- prepared faculty member is $41,036. The average salary for a full time MSN-prepared faculty member is $45,596. The difference between these full-time faculty salaries is $4,560 annually. The salary difference for part-time faculty at the BSN level and MSN level of preparation is $1.91 hour. As of November 1, 2007, there are a total of 474 full time (FT) and 462 part time (PT) faculty positions budgeted across all ADN programs. There are 356 FT budgeted in non-accredited NCCCS programs. As of November 1, 2007, there were a total of 138 FT and 77 PT budgeted positions across all PN programs. There are 125 FT and 64 PT budgeted in non-accredited NCCCS programs. Associate Degree Nursing Programs Using the current vacancy information for academic year for those programs affected by the proposed rule, there were 48 FT and 70 PT vacant positions at some point during the year. 72% of the current full time faculty and 26% of the part-time faculty have a master s degree or higher. If these trends continue, the proposed rule revision would impact the annual salary cost for 66 faculty members (14 FT and 52 PT). Costs for filling vacant ADN faculty positions: 1. Formulas for determining costs : (a) For salaried FT faculty: ($difference in salary) X (number of faculty affected) = (increased annual salary costs) (b) For PT faculty: ($difference in salary) X (hours per week worked) X (number of weeks worked) = (increased annual salary costs) Assuming a PT faculty person works 20 hours per week for 2 semesters per year, the difference would be $1.19 times 20 hours/week times 15 weeks times 2 semesters or $714. (Note: Some PT Faculty work only one semester per year.) (c) Annual cost of salary increase assumes that the same percentage of future faculty would have master s degrees as current faculty in the absence of this rule change. 2. Estimated costs are: 14 FT faculty X $4,560 = $63, PT faculty X $714 = $37,128 Total increase in annual cost for ADN faculty would be $100,968 per year at the current salary level. Practical Nursing (PN) Programs 4

5 Using the current vacancy information for academic year for those programs affected by the proposed rule, there were 18 FT and 11 PT vacant positions at some point during the year. 49% of the current FT faculty and 26% of the PT faculty have a master s degree or higher. If these trends continue, the proposed rule revision would impact the annual salary cost for 18 faculty (9 FT and 9 PT). Costs for filling vacant PN faculty positions: 1. Formulas for determining costs are the same as noted above for ADN faculty. 2. Estimated costs are: 9 FT faculty X $4,560 = $41,040 9 PT faculty X $714 = $6,426 Total increase in annual cost for PN faculty would be $47,466 at the current salary level. Total increase in annual salary cost for faculty in both PN and ADN programs affected by this proposed rule revision would be $148, Impact on Private Sector: As of November 1, 2007 there are 13 full time (FT) and 13 part time (PT) budgeted faculty positions in the 2 private practical nursing (PN) programs (ECPI Raleigh, ECPI-Charlotte) in North Carolina. Using the vacancy rates and master s degree percentages for NCCCS PN faculty, the proposed rule revision would impact the annual salary cost of at most two PN faculty positions (1 FT and 1 PT) per year. Costs for filling vacant PN faculty positions: 1. Formulas for determining costs are the same as noted above for ADN and PN faculty in the NCCCS. 2. Estimated costs are: 1 FT faculty X $4,560 = $4,560 1 PT faculty X $714 = $714 Total increase in annual salary cost for PN faculty in the private sector affected by the proposed rule would be $5,274. Cost of Tuition, Fees, Books and Supplies (Cost to individuals): The estimated cost of $6,313 to obtain a Masters Degree used in this Fiscal Note is based upon the rates published by the University of North Carolina System for for a Master s Degree in Nursing at the University of North Carolina at Chapel Hill: ($4,113 5

6 tuition), cost of books (estimate of $500 per semester), fees ($1,000 per year), supplies and materials costs ($100 per semester). There would be a total cost of $542,918 in tuition, fees, books and supplies for the 86 potential faculty members. It should be noted that the NC General Assembly has appropriated $2.4 million for nursing faculty scholarships for up to $15,000 per year for two years for master s candidates and for three years for doctoral candidates. This equates to 160 scholarships according to the Director of Grants, NC State Educational Assistance Authority (NCEAA). One hundred twenty-one (121) scholarships have been awarded for FY Unfortunately the NCSEAA could not provide data on the number of scholarships having been awarded to current faculty in NCCCS. Priority preference for half of these funds goes to applicants currently working in NC Community Colleges. 4. Local Impact: None 5. Federal Impact: None Benefit Estimates o Strengthen the capacity of nursing programs by assuring that faculty standards support the preparation of a future nursing work force that is better prepared to meet the challenges of North Carolina s changing population and the technological demands of patient care in the years ahead. o Ensure that graduates of these programs have the education necessary to safely and competently practice nursing. o Facilitate articulation and continuing education of graduates of nursing education programs that meet national accreditation standards for faculty preparation. o Contribute to the improvement of retention rates for students in nursing education programs that meet these national standards. o Increased annual earnings for individual faculty members totaling $153,708 per year ($148,434 from state funds and $5,274 from the private sector). 6