IOWA ADVANCED PRACTICE NURSE TRACKING SYSTEM



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IOWA ADVANCED PRACTICE NURSE TRACKING SYSTEM ADVISORY COMMITTEE MEETING September 0, 0 Iowa Health Professions Tracking Center Office of Statewide Clinical Education Programs Carver College of Medicine The University of Iowa

Iowa Advanced Practice Nurse Tracking System Advisory Committee Meeting September 0, 0 0:0am pm Carver College of Medicine 6 CMAB -Agenda- I. Meeting Agenda & Participant List II. Introduction/Background III. Annual Benchmarks IV. Geographic Distributions V. Trends & Projections VI. Comparisons

Iowa Advanced Practice Nurse Tracking System Advisory Committee September 0, 0 Meeting Participant List 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 Linda Thiesen Data Analyst/Assistant Manager K:\DOCUMENT\NP\YearEnd\0Yearend\ParticipantList.docx

Iowa APN Tracking System Advisory Committee Meeting September, 0 Advisory Group Members Present: Colleen Brems (for Judith Collins) Diane Huber Laura Hudson Kendra Williams-Perez Absent: Brenda Hoskins OSCEP Staff Present: Theresa Dunkin Carole Kron Linda Thiesen Called to order: 0:0 AM Adjourned: : AM Location: College of Medicine 6 CMAB Iowa City, IA Prepared by: Linda Thiesen AGENDA DISCUSSION ACTION/DEADLINE/WHO II. Minutes Review of 9/6/ meeting minutes; approved as submitted. III. Review 0 Annual Report A. Greeting & Introductions B. Overview & History C. Annual Benchmarks Judy Collins was unable to attend. Thanks to Colleen Brems attending as the representive for the Iowa Nurses Association T. Dunkin reviewed history of OSCEP/HPINV tracking system and data collection methods which include phone calls to each worksite, subscription to a news clipping service, individual survey, and licensure information from the Iowa Board of Nursing.,8 APNs identified at 0 yearend. C. Kron stated that data across all benchmark areas was consistent with previous year. K:\DOCUMENT\NP\YearEnd\0Yearend\0 Minutes 9--.doc

AGENDA DISCUSSION ACTION/DEADLINE/WHO Discussion of eventual depletion of CNS as specialty since the final testing for this certification is coming up shortly. The certification will remain in effect, for those certified, as long as the certification is kept current. No new certifications will be offered. There were approximately 00 graduates from Allen College and the UI. Multiple worksite discussion. - Faculty still need clinical hours for certification, so they often have two worksites. Advisory Group expressed interest in reviewing age details of state employees; specifically UI vs others to determine possible impact on retirement. OSCEP D. Geographic Distribution There are still only three counties with no APNs based within county borders. There was a 0% increase in active Iowa APNs from 999 to 0. 0 and over map shows more yellow counties (higher percentage of under 0 APNs) in 0. Over 0 detail illustrates that retirements don t occur at a single age, but rather taper over time. K:\DOCUMENT\NP\YearEnd\0Yearend\0 Minutes 9--.doc

AGENDA DISCUSSION ACTION/DEADLINE/WHO E. Trends & Projections Projected growth through 00 was reviewed. Projections based solely on previous yearend numbers. E. Workforce Comparisons Opportunities Directory shows increase in demand for NP only positions. IV. Discussion Items Include an average age for psychiatry related professions for physicians and APNs. D. Huber is interested in a breakdown of APNs by specialty and age as demand for preceptors continues to increase. Future impact of tele-medicine in relation to all medicine, including APNs. Prison systems, rural areas, gero nursing homes, etc. will/are benefiting from this development. OSCEP OSCEP K:\DOCUMENT\NP\YearEnd\0Yearend\0 Minutes 9--.doc

Annual Workforce Report* Date APNs December 0 68 January 0 600 Gain + 8 * For year ending --0 Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 0 Np00.ppt

Gender Distribution 0 Female 88% Male % Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 0 Female 8 Male 0 Total 68 K:\DOC\NP\YE\0\Annual_Report\NP0.PPT

Age Distribution 0 Age Category No. % Cumulative % < 0 66 % % 0-9 00 % 7% 0-9 8 9% 86% > 60 % 00% 68 00% >60 % <0 % 0-9 9% Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 0 0-9 % K:\DOC\NP\YE\0\AnnRpt\np8pie.PPT

Full Time vs. Part Time* 0 Percent Full Time 6 9% Part Time 8 8% Total 68 00% *PT = < hours/week Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Medicine UI Carver College of Medicine, June 0 K:/DOC/NP/YE/0/Annual_Report/FTE-6.PPT

Iowa APNs Age Distribution Full Time vs. Part Time* 0 Age FT % PT % Cumulative % < 0 7. 9..6 0-9 70.0 0.8 7. 0-9 8 6.6 7. 86. > 60 0.9.9 00% *FT = > 6 9.8 8 8. PT = < Source: University of Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 0 NP\YE0\AnnRpt\FTvPTage.PPT

Detail of Age > 0 0 APNs 00 90 80 70 60 0 0 0 0 0 0 Age 0 6 7 8 9 60 6 6 6 6 6 66 67 68 69 70 7 7 7 7 7 76 77 78 # in Iowa 0 0 9 8 6 7 0 7 9 7 6 0 0 0 Total number of APNs age 0 and over = 78 (%) Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 0 6 K:NP\YE0\AnnRpt\Over0-Bar-6.PPT

Principal Professional Activity 0 Number Percent Private Practice 70 7.% State Facility 67 9.9% Public/Community Health 9.6% Federal 6.7% Teaching/Research.0% Hospital Medicine.% Urgent Care 7.0% Student Health 0.8% Administration 0.% Total 68 00% Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 0 7 K:\DOC\NP\YE\0\Annual_Report\NP6.PPT

Specialties 0 Number Percent Family NP (FNP) 77.8% RN Anesthetist (CRNA) 99 7.8% Pediatric NP (PNP) 8 8.% Ob/Gyn (ONP)/Women s Health 90.% Psychiatric NP (PSNP) 87.% Adult NP (ANP) 7.% Nurse Midwife (NMW).% Acute Care NP (ACNP) 7.8% Gerontological NP (GNP)/CGE.% Neonatal NP (NNP).8% CNS Adult Psych (CAP) 9.% Other* 7.% Total 68 00% *CNS, CNS Med Surg, School NP, CNS Oncology, CNS Adult Health, CNS Child/Adolescent Psych Source: Office of Statewide Clinical Education Programs, UI Carver College of Medicine Iowa Health Professions Tracking Center, June 0 8 K:\DOC\NP\YE\0\Annual_Report\NPSPEC.PPT

Locations by Community Population 0 Cumulative Community Size APNs % % <,000..,000 -,999 7 6..,000-9,999.9. >0,000 9.8 00% Totals 68 00% Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 0 9 K:Doc/NP/YE/0YE/AnnualReport/0_.PPT

Communities Gaining/Losing APNs 0 Community Size #Entering #Leaving Net <,000 8 +7,000 -,999 7 +,000-0,000 6 +6 >0,000 0 7 +7 Total 8 +8 Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 0 0 K:Doc/NP/YE/0YE/AnnualReport/0-chart.PPT

ADVANCED PRACTICE NURSES (68) 0 Lyon Sioux Plymouth 8 Woodbury 6 Monona Harrison Osceola O'Brien 0 Cherokee Ida Crawford 6 Pottawattamie Dickinson Shelby 8 Clay 9 Buena Vista 7 Sac Audubon Palo Alto Pocahontas Carroll Cass Emmet Calhoun Greene Guthrie Adair Kossuth Humboldt Webster 6 Boone 6 Dallas 8 Madison Winnebago Hancock Wright 7 Hamilton 7 Story Polk 90 Warren Worth Cerro Gordo 8 Franklin Hardin 7 Jasper 8 Marion Mitchell Marshall 0 Floyd Butler 6 Grundy Howard Chickasaw Black Hawk Tama Mahaska Bremer 7 96 Poweshiek 6 Winneshiek Allamakee Benton Keokuk 6 Fayette 9 Buchanan Iowa Clayton Delaware Linn 0 Johnson Washington 8 8 Dubuque Jones Cedar 69 Muscatine Jackson 6 Clinton Scott 86 Mills Fremont 7 7 Montgomery Adams Union Clarke Lucas Monroe Wapello 6 6 9 Page Taylor Ringgold Decatur Wayne Appanoose Davis 9 9 Jefferson Van Buren Louisa Henry Des Moines 7 Lee 6 KEY: 0+ (6) 6-9 () - () (6) 0 () Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 0 K:NP/YearEnd/0/Annual_Report/np0.cdr

Family Nurse Practitioners (77)* 0 Lyon Osceola Palo Alto Winnebago Hancock Worth Mitchell 6 Sioux O'Brien Dickinson Clay Emmet Kossuth Cerro Gordo 6 Floyd Howard Chickasaw Winneshiek Allamakee 8 Fayette Clayton Plymouth Woodbury Monona Harrison Cherokee 9 Mills Ida Pottawattamie Fremont Crawford Shelby Buena Vista Sac Montgomery Page Audubon Pocahontas Carroll Cass Calhoun Adams Taylor Greene Guthrie Adair Humboldt Webster Union Ringgold Boone Dallas 7 Madison Hamilton Clarke Decatur Polk Franklin Hardin Lucas Wayne Butler Grundy Monroe Black Hawk Tama Bremer Davis Benton Keokuk Van Buren 7 7 Story Marshall Jasper 6 Marion *6% of Iowa s advanced practice nurses Wright 7 Warren 7 9 6 Appanoose Mahaska 9 Poweshiek 8 Wapello 9 Buchanan Iowa 6 Jefferson Delaware Linn 9 Washington 6 Johnson 9 Henry 0 Lee Louisa Jones Cedar Des Moines 7 Dubuque 0 Muscatine Jackson Clinton Scott 6 KEY: 0+ (8) 6-9 () - () () 0 () Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs Carver College of Medicine, June 0 K:Doc/NP/YE/0/np0.cdr

Primary Care*: APNs (,6) and Physicians (,60) 0 Lyon Osceola / 0 / Sioux O'Brien /6 6/7 Dickinson 6/9 Clay 7/ Emmet Palo Alto /6 Kossuth Winnebago Hancock Worth /6 / 0/ /7 / Cerro Gordo /8 Mitchell / Floyd /9 Howard / Chickasaw /8 Winneshiek Allamakee / /9 Fayette Clayton Plymouth /0 Woodbury 8/9 Monona / Harrison /8 Cherokee 9/ Mills Ida Pottawattamie Fremont /7 /60 /9 / Crawford Shelby Buena Vista / /8 Sac / Montgomery Page Audubon Pocahontas Carroll 7/0 / Cass / / Calhoun / Adams Taylor Greene /6 Guthrie / Adair / Humboldt / Webster 0/ Union Ringgold Boone Dallas Madison Hamilton /6 /6 /7 Wright /0 7/ 96/7 Clarke Decatur Polk Franklin Hardin 6/ Lucas Wayne Marshall Jasper 6/ Marion 7/ Butler Grundy / 6/9 Monroe Black Hawk 80/7 Tama Mahaska Bremer /9 Poweshiek Davis Benton Keokuk Buchanan Jefferson Van Buren / 8/9 /0 / / 9/ /7 / /7 Story 8/69 Warren /7 /9 0/ /9 / /8 / Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs Carver College of Medicine, June 0 Appanoose /7 /8 Wapello 8/0 / Iowa Delaware Linn 8/8 Johnson Washington /9 6/7 0/7 /68 *Primary Care Specialties: APNs: ANP-7; FNP-77; GNP/CNS-Gero-; NMW-; Ob-Gyn/WHNP-90; PNP-8 Physicians: Family Med (incl EM w/fm res)-6; Gen Int Med -6; Ob/Gyn-7; Peds-6 / 6/ /0 /7 / 7/ /7 /0 Henry / Lee Louisa 0/7 Dubuque Jones /8 Cedar / /96 Muscatine /6 0/ Des Moines / Jackson /8 Clinton 0/ Scott 6/6 KEY: K:Doc/NP/YE/0/AnnRpt/PrimaryCare.cdr APNs > Phys ()

Lyon Sioux IOWA APNs Certified Registered Nurse Anesthetists (99) 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 Wright Hamilton Story Polk Warren Franklin Hardin Marshall Jasper Marion Butler Grundy Black Hawk Tama Mahaska Bremer Poweshiek 6 Benton Keokuk Buchanan Iowa Delaware Linn Johnson 8 7 Washington Louisa Dubuque 7 7 Jones Cedar Muscatine 6 Jackson Clinton Scott Mills Fremont Montgomery Page Adams Taylor Union Ringgold Clarke Decatur Lucas Wayne Monroe Appanoose Wapello Davis 6 Jefferson Van Buren Henry Lee Des Moines 9 KEY: CRNAs Counties > () 6-0 (9) - () - 0 () (7) Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 0 K:Doc/NP/YE0/CRNA-Cty.cdr

Communities with CRNAs (66) 0 Spirit Lake () Estherville Sheldon () Mason City () Orange City () Spencer (7) Algona LeMars () Clarion () Cherokee () Hampton Storm Lake () Sioux City () Fort Dodge (6) Iowa Falls Webster City Cresco Decorah () Waukon () West Union () Charles City () Guttenberg () Waverly () Dubuque (7) Manchester (7) Waterloo (6) Grundy Center Lake City Ogden* Boone () Marshalltown () Onawa Denison () Carroll Ames Jefferson Manning Panora* Grinnell () Harlan Newton () Des Moines () Atlantic () W Des Moines (0) Pella () Council Bluffs (7) Knoxville () Creston () Corning Red Oak () Shenandoah () Hamburg Winterset Chariton Albia Leon Bloomfield (6) Oskaloosa () Maquoketa Iowa City (8) Davenport () Muscatine (6) Mount Pleasant West Burlington (9) Fort Madison () Clinton *Locum Tenens Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 0 NP\Yearend\0\NP0-CRNA_Comm.CDR

Psychiatric Nurse Practitioners* () 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 PSNP- 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- Franklin Hardin Marshall PSNP- Jasper Marion PSNP- Floyd Butler Grundy Chickasaw Black Hawk Tama Mahaska Bremer Poweshiek PSNP- PSNP- PSNP- Benton Keokuk Fayette Buchanan Iowa Clayton Delaware Linn CAP- PSNP- Johnson CAP-6 CCAP- PSNP-8 Washington 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 Davis Jefferson PSNP- Van Buren Henry Des Moines CAP- PSNP- Lee PSNP- 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 0 6 CCAP/PSNP CAP-9; PSNP-87; CCAP- K:DOC/NP/YE/0/PsychNP.cdr

Psychiatric Nurse Practitioners and Psychiatrists 0 Lyon Osceola Dickinson Emmet Kossuth Winnebago Worth Mitchell Howard Winneshiek Allamakee Sioux O'Brien 0/ Clay / Palo Alto Hancock /0 Cerro Gordo / Floyd Chickasaw 0/ Fayette Clayton Plymouth Woodbury Cherokee Buena Pocahontas Humboldt Wright Franklin Butler Vista / /0 Webster Ida Sac Calhoun Hamilton Hardin Grundy /7 0/ 0/ Bremer Black Hawk Buchanan Delaware Tama Benton Monona Crawford Carroll Greene Boone Story Marshall /0 / / / / 0/ Harrison Shelby Audubon Guthrie Dallas Polk Jasper Poweshiek Iowa Johnson /0 / /8 0/ /76 Linn /0 Dubuque Jones Cedar /6 Muscatine Jackson Clinton /0 Scott 0/9 Pottawattamie Cass Adair Madison Warren Marion Mahaska Keokuk Washington / / /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 / KEY: / /0 0/ Lee / Psych > APNs () APNs > Psych (7) First Number is APN/second is psychiatrist Average Age: Total APNs: Psychiatrist - Total Psychiatrists: Psych NP - Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 0 7 Psych Only-No APNs (9) APNs Only-No Psych (7) APNs = Psych () No Psych or APN (6) K:\Doc\NP\YE0\PsychAPN-Phys.cdr

Certified Nurse Midwives () 0 Lyon Osceola Dickinson Emmet Kossuth Winnebago Worth Mitchell Howard Winneshiek Allamakee Sioux O'Brien Clay Palo Alto Hancock Cerro Gordo Floyd Chickasaw Fayette Clayton Plymouth Cherokee Buena Vista Pocahontas Humboldt Wright Franklin Butler Bremer Woodbury Ida Sac Calhoun Webster Hamilton Hardin Grundy Black Hawk Buchanan 7 Tama Benton Delaware Linn Dubuque Jones Jackson Monona Crawford Carroll Greene Boone Story Marshall Cedar Clinton Harrison Shelby Pottawattamie Audubon Cass Guthrie Adair Dallas Madison Polk 0 Warren Jasper Marion Poweshiek Mahaska Iowa Keokuk Johnson 6 Washington Muscatine Scott 7 Louisa Mills Fremont Montgomery Page Adams Taylor Union Ringgold Clarke Decatur Lucas Wayne Monroe Appanoose Wapello Davis Jefferson Van Buren Henry Lee Des Moines KEY: - 0 () - (6) (0) CNM in 0 counties 0 (79) Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 0 8 K:Doc/NP/YE0/CNM.cdr

Communities with APNs (06) 0 Larchwood Spirit Lake () Lake Mills () Cresco () Lake Park Estherville () Lansing Milford Armstrong () Decorah () Rock Valley Okoboji Sheldon (8) Osage () Clear Lake () Waukon () Sioux Graettinger Calmar () Center (6) Hartley Mason City (6) Spencer (7) Wesley Sanborn Britt () Garner Emmetsburg () New Hampton () West Union () Orange City (6) Algona Elkader () Hawarden () Royal () Kanawha Belmond Charles City () Sumner () Arlington () Guttenberg () LeMars (6) Pocahontas () Humboldt () Clarion () Rockford Allison Clarksville Oelwein () Cherokee () Hampton () Waverly () Denver Edgewood () Kingsley () Storm Lake (7) Eagle Grove Shell Rock () Moville Parkersburg Manson Fort Dodge () Ackley () Independence Dyersville Cedar Falls (8) Dubuque (66) Sioux City (8) Sac City Sergeant Bluff () Rockwell City Iowa Falls () Waterloo (87) Winthrop Evansdale Manchester (8) Webster City () Sloan Lake View Gowrie () Grundy Center (0 Jewell () Hubbard () Cascade () Ida Grove () Bellevue Dayton Reinbeck Dysart Story City Monticello Lake City Ogden () Marshalltown (9) Maquoketa () Mapleton () Boone () Zearing Ames () Onawa Denison (6) Carroll (0) Hiawatha (8) Shellsburg State Center Tama () Jefferson () Marion () Dunlap Clinton () Earling Manning () Grimes Polk City Cedar Rapids (9) Woodbine Audubon Ankeny (9) Grinnell () Marengo () Clarence Lowden Guthrie Center North Liberty () Mondamin Johnston () Panora () Coralville (8) Harlan () Urbandale (0) Altoona () Montezuma () Tipton LeClaire Adair Newton (7) Waukee () Iowa City (0) West Branch () Windsor Heights () New Sharon Clive (6) West Liberty Bettendorf (0) Missouri Valley() Pleasant Hill Sully Wilton Davenport (6) Atlantic (7) W Des Moines () North English Muscatine (9) Shelby Wellman Stuart () Des Moines (7) Pella (7) Underwood Sigourney () Fontanelle Pleasantville Washington () Council Bluffs () Indianola () Knoxville (6) Greenfield Melcher-Dallas Richland () Wayland Winfield Winterset () Eddyville () Oskaloosa (6) Creston (6) Mount Pleasant () Corning Osceola () Glenwood Ottumwa (7) Fairfield () Red Oak () Chariton () New London () Humeston () Albia () West Burlington (9) Shenandoah (7) Villisca Corydon () Leon () Bloomfield (9) Keosauqua () Burlington () Sidney Clarinda (6) Mount Ayr () Seymour () Centerville () West Point Hamburg () Bedford () Lamoni Farmington Lineville () Fort Madison (9) Keokuk (6) Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 0 9 NP\Yearend\0\NP0_Comm.CDR

Age 0 and Over 0 Lyon Osceola Dickinson Emmet / /8 / Sioux O'Brien Clay Palo Alto 9/ 7/0 /9 / Kossuth / Winnebago / Hancock / Worth Cerro Gordo /8 Mitchell / Floyd / Howard / Chickasaw / Winneshiek 6/6 Fayette Allamakee / Clayton Plymouth Cherokee Buena Pocahontas Humboldt Wright Vista Franklin Butler Bremer /8 7/ /7 0/ 0/ /7 0/ /6 Webster Woodbury Ida Sac Calhoun Hamilton Hardin Grundy 0/ /6 / / / /6 /7 /7 Black Hawk Buchanan Delaware Dubuque /96 / /8 9/69 Tama Benton Linn Jones Monona Crawford Carroll Greene Boone Story Marshall 0/ /0 0/ / /6 6/ / /6 / /0 0/ 6/7 /9 /8 Harrison Shelby Audubon Guthrie Dallas Polk Jasper Poweshiek Iowa Johnson / / / / 8/8 9/90 /8 / 0/6 0/ / 76/69 Pottawattamie Cass Adair Madison Warren Marion Mahaska Keokuk Washington Cedar / Muscatine 6/ Jackson /6 Clinton / Scott 8/86 / /7 / / 0/ 7/ 6/7 / 0/ Louisa Mills / Fremont / Montgomery /6 Page 8/ Adams / Taylor / Union /6 Ringgold 0/ Clarke 0/ Decatur / Lucas / Wayne /9 Monroe / Appanoose / Wapello 7/9 Davis /9 Jefferson / Van Buren / Henry /7 Lee 7/6 Des Moines / > 0% age 0 and over (0) < 0% age 0 and over (6) st number > 0 years of age / nd number = total in county = 0 APNs () Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 0 0 NP\YE\0\AnnReport\NP08.cdr

700 600 00 00 00 00 00 000 900 800 700 600 00 6 '99 '00 707 80 '0 '0 ACTIVE IOWA APNs 999-0 87 '0 '0 907 90 997 '0 '06 Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 0 0 '07 '08 087 76 '09 '0 60 ' 600 97 66% Increase ' ' K:/Doc/NP/YE/0YE/NP0.PPT 68

Net Gain/Loss 999-0 APNs 0 80 0 0 80 0 '99 '00 '0 '0 '0 '0 '0 '06 '07 '08 '09 '0 ' ' ' Entering 0 96 88 7 96 9 0 9 9 78 Leaving 0 7 7 7 6 8 6 8 Net Gain/Loss 9 7 97 68 67 7 89 8 9 0 8 Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 0 K:Doc\NP\YE\0YE\NP68.PPT

600 0 00 0 00 0 00 0 00 0 00 0 0 *Includes unknown 66 All IOWA APNs Age Distribution Comparison 999 vs. 0 00 79 8 8 Under 0 0-9 0-9 60 and Over Year Total APNs Average Age Median Age 0 68 6 6 999 6* Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 0 K:Document\NP\0YrEnd\70.PPT

Working in Communities of <,000 999 0 700 00 00 00 900 700 00 00 6 707 98 9 All APNs 80 8 87 <,000 Comm 907 90 997 8 7 7 89 0 8 087 76 7 60 8 68 600 97 6 9 7 0 00 '99 '00 '0 '0 '0 '0 '0 '06 '07 '08 '09 '0 ' ' ' Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 0 K:/DOC/NP/YE//0/Annual_Report/CommKNP0.ppt

Towns with APNs 0 0 0 00 90 80 70 60 0 0 0 0 IOWA APNs Towns With at Least One APN 999-0 8 6 7 7 78 8 79 0 0 '99 '00 '0 '0 '0 '0 '0 '06 '07 '08 '09 '0 ' ' ' Year Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 0 % Increase 06 K:/DOC/NP/YE/0/Annual_Report/NPS06.ppt

Communities with APN or Physician 999-0 Communities 0 0 0 0 0 00 90 80 70 60 0 0 0 0 9 0 0 9 9 % Decrease 78 79 7 7 6 8 Towns With At Least One APN Towns With At Least One PHY 9 7 0 0 06 8 '99 '00 '0 '0 '0 '0 '0 '06 '07 '08 '09 '0 ' ' ' Year % Increase Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 0 6 K:/DOC/NP/YE/0/Annual_Report/NPS06 w PHY

IOWA HEALTH PROFESSIONS INVENTORY Composition of Workforce - 0 Physicians 7 Pharmacists 90 Dentists 7 Nurse Practitioners 68 Physician Assistants 79 Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 0 7 K:\DOC\NP\YE\0\IAWorkforceSum

IOWA HEALTH PROFESSIONS INVENTORY 00-0 6000 00 000 00 000 00 000 00 000 00 000 00 0 80 97 00 96 7 8 90 69 7 96 7 8 860 90 9 66 7 9 7 80 907 997 087 60 97 68 7 80 8 8 69 680 7 79 '0 '0 '0 '07 '09 ' ' Physicians 9% Increase Pharmacists 7% Increase APNs 0% Increase Dentists 0% Increase PAs 6% Increase Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 0 8 K:\Doc\NP\YE0\GRAPHICS\HP-comptrend.PPT

IOWA HEALTH PROFESSIONS INVENTORY Composition of Workforce - 0 Net Gain/Loss Summary Entering % Leaving % Net % Total Physicians 7.% 9.9% 7.% 7 Pharmacists 80 6.% 70.9% 0 0.% 90 Dentists 78.0% 7.0%.0% 7 Nurse Practitioners 8.9% 8.0% 8.9% 68 Physician Assistants 78 9.8% 6.8%.0% 79 Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, June 0 9 K:Document/NP/0YrEnd/IAWorkforceSum_NetGain_Loss.PPT

IOWA HEALTH PROFESSIONS INVENTORY Composition of Workforce - 0 Gender Male % Female % Total Physicians 0 7% 60 8% 7 Physician Assistants 8 0% 6 70% 79 Dentists 60 7% 97 % 7 Pharmacists 9 9% 78 6% 90 APNs 0 % 8 88% 68 Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 0 0 K:DOC/NP/YE/0t/HP-Comp-GENDER.PPT

IOWA HEALTH PROFESSIONS INVENTORY Composition of Workforce 0 Age Physicians Physician Assistants Dentists Pharmacists APNs <0 6 % 7 7% 68 0% 99 % 6 % 0-9 80 8% 8 % 89 9% 700 % 0 % 0-9 690 9% 7 % 9 % 606 % 8 9% > 60 69 0% 6 8% 07 6% 9 % % Total 7 79 7 898* 68 *Total pharmacists = 90: does not include VA pharmacists, age unknown Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 0 K:DOC/NP/YE/0/Annual_Report//IA-WF-Sum-AGE

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 <,000.6% 0.%.%,000-,999 99 7 7 07 9. 7. 6.,000-9,999 8 0 99.0 8.8. 0,000-9,999 8 8 7 6 0 9. 9. 7.6 0,000-99,999 8 8 8 6 7 6 6..0. > 00,000 09 8 8.. 7. Total 06 69 68 7 79 00% Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 0 K:Doc/NP/0YrEnd/\IA Workforce Community Dist 0.PPTX